When acute complications develop in a minor who had an abortion
without parental consnet that now requires hospitalization, how do you
treat your pt when she continues to refuse to inform her parents about
the abortion and still protect her privacy? Specifically when the
hospital is refusing admission without parental consent because she is
a minor and without the pt's proof of insurance (which is carried by
her parents)abiding by FL law and HIPPA regulations?

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Request for Question Clarification by welte-ga on 06 Apr 2005 06:44 PDT

Dear Lindzhrn,

Thank you for your question.  The Alan Guttmacher Institute is the
best resources for abortion and women's health research.  From their
site, the Florida law requiring parental notification has been
permanently enjoined by court order, meaning that the policy is not
legally in effect.  Perhaps your hospital is not aware of this.  Here
is a link to the table of state policies on parental notification:
http://www.guttmacher.org/statecenter/spibs/spib_PIMA.pdf

If the hospital is refusing to admit her based on insurance, then it
can only be a private hospital. I would transfer her to a public
hospital, which must treat anyone regardless of insurance.  Any minor
can be admitted without "parental consent" in an emergency - it
happens all the time on the trauma service.  Payment, parental
notification, and HIPPA are all worked out later when the patient is
stable.

A common technique is to admit the minor; if her parents must be
notified, they can be told that she requires admission for an Ob/Gyn
problem, without specifying what it is.  Another possibility is to get
the hospitals legal counsel involved to determine how to go about
bringing this quickly before a judge for a hearing.

Questions: Is this a public, catholic, or private hospital.  What type
of insurance does the family have (e.g. Medicaid or something else)?

              -welte-ga

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Clarification of Question by lindzhrn-ga on 06 Apr 2005 08:07 PDT

The question stems from a scenario from an Ethics class I am enrolled
in. I am a Nurse Practioner student and had to research this topic for
debate. I was having a hard time coming up with the approprite
resources for my preparation.
The scenario didn't state this insurance carrier or hospital type. I
agree with your asumption that it has to be a private hospital and
that some sort of explanation about an ob/gyn problem could be told to
the parents, however the scenario goes on to state that the patient
requires further surgical intervention in the form of a D&C (dilation
and curettage)That's where the problem lies, getting surgical consent
from the parents without telling them the real reason for the
hospitalization. Thanks for your feedback.

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Request for Question Clarification by welte-ga on 07 Apr 2005 09:24 PDT

Thanks for getting back to me... I think then that the PDF I mentioned
should point you in the right direction.  A D&C can be viewed as
completion of the abortion, so under Florida law, the parents do not
need to be notified based on the permanent enjoinment which nullifies
the parental notification law there.

         -welte-ga