Parental Rights and Adolescent Confidentiality
Parental Rights and Adolescent Confidentiality
The American College of Pediatricians (ACPeds) affirms that parents provide the foundational role of support, nurturance, and guidance for their children.1 That role includes the fundamental right to direct the child’s upbringing. It is essential that society supports parents by respecting their natural right and legal authority to make decisions for their children, including educational and medical decisions. Parents, in this context, include biological and adoptive parents, as well as state-appointed guardians and custodial grandparents.
Parents have no right to physically, sexually, or emotionally abuse or neglect their children. Parents also do not have the right to agree to mutilating function-reducing surgeries or potentially sterilizing treatments except when necessary to preserve their child’s life from a physical illness (e.g., agreeing to chemotherapy treatments for cancer).
Disciplinary measures such as time-out, transient restraint, and properly applied disciplinary spanking do not qualify as physical abuse.2 Pediatricians are obligated to attempt to prevent potential abuse before it occurs through education of parents, mediation with parents and adolescents, and referrals for counselling when appropriate. If pediatricians suspect abuse is occurring, or has occurred, they are obligated to report it and protect the child/adolescent.
Current scientific research demonstrates that:
- Children and adolescents have immature brain development indicating the need for strong parental guidance in decision making. Brain development in humans continues until the early to mid twenties, particularly in the areas involving decision making under stress.3
- Children and adolescents do better in an authoritative environment in which parents state their expectations and provide consequences for inappropriate behavior.4
- Adolescents are less likely to participate in high-risk behaviors if their parents are “hands on” parents who monitor and guide all of their activities.3,4
- Adolescents are less likely to participate in high-risk behaviors if they feel connected to their parents and family.3,4
- Successfully navigating adolescence and avoiding high-risk behaviors will allow youth to enter adult careers, relationships, responsibilities, and parenting with better skills and increased likelihood of optimal outcomes.
Laws regarding adolescent confidentiality and parental notification or consent vary widely among states. All states allow adolescent confidentiality regarding sexually transmitted diseases, but not all states require it. Some states require that one or both parents be notified of a minor’s abortion, others require consent of one or both parents, and others deny parents any knowledge or rights. Pediatricians should be knowledgeable regarding the legal requirements of the state in which they practice. When feasible, ACPeds recommends pediatricians offer to assist their adolescent patients in confiding in their parents and encourage open communication between parent and child/adolescent. Often parents know family medical history of which adolescents are unaware. Discussing the benefits of avoiding sexual activity before marriage, of keeping the brain drug-free, etc. with parents and the adolescent in the exam room together, can open lines of conversation. Laws mandating adolescent confidentiality put pediatricians in an adversarial position and interfere with the ability of parents to provide needed guidance as the primary educators of their children. Such laws are harmful to both adolescents and parents. Thus the American College of Pediatricians opposes them.
Approved by the ACPeds Board of Directors (May 2025)
Approved by ACPeds Members (June 2025)
Corresponding ACPeds Referenced Paper:
Adolescent Confidentiality (Sept. 2020)
Other Pertinent ACPeds Referenced Papers:
Discipline of the Child (Dec. 2021)
The Adolescent Brain: Under Construction (May 2022)
The Roles, Responsibilities and Rights of Parents (May 2023)
Parental Involvement and Consent for a Minor’s Abortion (May 2016)
