Ethical Question

L&D_RN_OH · Nov 30, 2003

In this area, pregnancy is not an automatic emancipation. We have to have consent from the parent for treatment, although the minor can make decisions for baby. Of course, the parent signs the consent form for treatment and delivery and care of baby, so beyond that, I don't know what they can refuse to let the pt have. I think it's something I'll have to ask when I go back into work. I haven't run into this.

Jrnalist2RNinOR · Nov 30, 2003

Does anyone know if there are any laws that if in a situation like that a nurse or dr could take over and tell the evil mother to get out and then administer pain meds?

It just seems so bad to have the mother there in the room...

BarbPick · Nov 30, 2003

The baby can't give the child up for adoption unless the Birth mother agrees. Teenaged girls are allowed privacy about birth control. The only time I can see a parent having a say is if the pregnant daughter is on life support.

angelbear · Nov 30, 2003

My sons 17 yr old at the time girlfriend gave birth to his son while she was still 17 baby's mom was very good to her daughter fortunately because she was calling the shots through labor. What confuses me is the 17yr old girls mom must sign for any and all care she recieves yet the 17yr old girl has to sign for the babies treatment. I know this because 17yr olds blood sugar sky rocketed while her mom was out of town. We could not get ahold of her mom but it ended up going high enough ER had to act to save her life. Yet when 17 yr olds mother was babysitting for baby and baby got sick 17yr old's mom had to locate her inorder to get treatment for baby. Just seems really screwed up to me. Sorry that all sounds so confusing I just couldnt figure out how else to say all this. Thanks for your patience.

kitty29 · Nov 30, 2003

Originally posted by crankyasanoldma
In my state the minor is emancipated and makes her own decision. It often seems the moms who do this are intent on punishing the pregnant teen. We make it clear to the patient that the decision is theirs, review the options and provide per the patients desire.

Same here

Dayray, RN · Nov 30, 2003

They have just changed the laws regarding pregnant minors in my state. Now the parent must give consent for all treatment and also have the right to know all confidential info.

I have had this situation in the past and have had good success with laying a guilt trip on the parent. I just look at them with a shocked look and ask "are you sure you want them to suffer" have never had 1 refuse for long after that.

even if parents do have decision making powers in your state. I have to wonder if a nurse could report this situation to Social services as abuse. I know there are laws about withholding treatment of minor children it seems this would fall under that same law. Now if it were a decision based on fear of sideeffects it would be differnt but not if it were made soley for the purpose of punishment.

However, there are some very negative attitudes about teen parents and I think this is why the laws are favoring the parents (regardless of there quality as such). I was on a council for prevention of teen pregnancy in my city until I became so disgusted with it I left. The general consensus was that teen parents were "bad kids" and the council directed all there efforts to empowering the parents. They just didn't seem to understand that in many cases (most in my experience) the parents are the problem.

CalvilloSN · Dec 1, 2003

Thank you all for the advise, I'm going to check out the law in my state to find out the correct procedure.

nekhismom · Dec 7, 2003

IN VA, the pregnant minor is emancipated, so she can make decisions for herself. I have seen laboring teens on TLC's "baby story" and other birth shows like that. I have seen some of the mom's refuse to let the teens have pain meds during labor. One girl I remember was screaming out in pain, and her mother was sitting there SMILING and saying, "this is what happens when you have sex", or something to that effect. I was HORRIFIED! The girl ended up having a c/s and needed the epidural anyway, and the mother was reluctant to have her get one then! I remember the doc's and nurses were very angry on this episode, but I guess in that state it was the mother's call. THe Dr. said that if the girl had rec'd the epidural in the first place, a c/s probably could have been avoided. It is a horrible thing to watch, and i think if I was faced with this situation, i would definately call social services. That has to be torture, plain and simple. ANy of us who have had children, whether with or without pain meds, all know that the pain of labor is HUGE and INTENSE. I can't imagine not having the option of pain control if it was wanted or needed.

mother/babyRN, RN · Jan 5, 2004

Pregnancy makes one an emancipated minor...She can make her own decisions. Unfortunately many staff people don't like to come up against this since the maternal figure seems to be so in charge. I will politely remind them that I have to go along with the wishes of the patient and then take both aside and mention that labor tends to make a vulnerable person feel even more so, and while I respect the fact that the mother feels one way, I have to respect the wants of my patient, whom I know desires pain meds...If the mother threatens to sue or otherwise causes problems, I will remind her that her daughter is a mom too and an emancipated minor....

Havin' A Party!, ASN, RN · Jan 5, 2004

Originally posted by mother/babyRN
Pregnancy makes one an emancipated minor...

FWIW, don't believe that's necessarily the rule in all jurisdictions.

fiestynurse · Jan 5, 2004

Minors have the ethical and legal authority to make medical decisions for themselves when they have reached the legal age of majority or become "emancipated." Most states recognize an emancipated minor as a person who meets one of the following criteria:

*self-supporting and not living at home

*married

*pregnant

*a parent

*in the military

In addition, most states allow treatment without parental consent for sexually transmitted diseases, pregnancy, and drug or alcohol abuse.

As a nurse you have a duty to advocate for your patient, who is this 15 year old girl. I would have the mother removed from the labor room!!!!

Havin' A Party!, ASN, RN · Jan 5, 2004

Here in PA, emancipation is determined on a case-by-case basis by a court.

"A judge will usually consider the following factors: age, marital status, ability to be self-supportive, and desire to live independently of parents.2 The court will consider whether the minor is employed and has a stable source of income 3 as well as a place to live."

Hence, the mere fact of a pregnancy is not determinative.

Suspect PA isn't alone on that.