Archived: Letter to Kennedy from Public Health Organizations

June 7, 2001

The Honorable Edward Kennedy, Chairman
Senate Health, Education, Labor & Pensions Committee
428 Dirksen Senate Office Building
Washington, DC 20510

Dear Mister Chairman:

We, the undersigned organizations, representing public health professionals, write to state our opposition to the parental consent provisions of the Tiahrt amendment passed as part of the Elementary and Secondary Education Act (H.R.1) in the House of Representatives. We are asking that you work to remove these provisions when the bill goes to conference. The provisions concerning both parental consent for health services and parental consent to participate in survey research are unnecessary in view of current systems for protection of minors and protection of research participants. They have great potential to set back our nation’s efforts to help at-risk children and youth.

While we believe that parental involvement in the health care decisions of unemancipated minors is valuable and should be encouraged, we must respect the overwhelming evidence that, when parental involvement is compulsory, some minors will decline to seek needed health care services. For instance, minors must feel comfortable seeking school-based mental health services. The centers for Disease Control and Prevention found that in 1999, one-fifth of all high-school students, and almost one-third of high-school girls, reported having seriously considered or attempted suicide in the prior year. Seventeen percent reported having carried a gun or other weapon to school in the prior 30 days. Between 1992 and 1997, approximately 3.4 million adolescents were reported to be victims of violent crime each year. School-based mental health services provide additional options for young people who seek the aid of responsible adults. Mandatory parental consent requirements limit the available outreach options for some adolescents who may desperately need help. They would also have the unwanted effect of restricting access to school-based health services for the growing number of children and youth who are uninsured.

Mandatory parental consent, beyond requirements imposed by local Institutional Review Boards and by state and local law, will also hamstring the ability of public health practitioners and researchers to obtain valid and usable data for characterizing the health status of children and adolescents and designing the most effective means of improving it. There is an existing, rigorous federal system for protection of human research subjects. Moreover, we believe that when those requirements are met, a decision on what further measures are necessary or desirable to address the participation of minors in survey research should be made by communities themselves. Local authorities are in the best position to balance the needs for population-based data with whatever additional privacy and parental consent concerns that community’s parents may have. If a mandatory federal requirement is in place, the ultimate losers will be children and youth whose health problems are not assessed or addressed.

We urge you to remove the provisions of the Tiahrt amendment from the Elementary and Secondary Education Act. While we support parental involvement in adolescent health, we believe that mandating parental consent ultimately fails to serve the health needs of America’s young people.

Please contact Sarah Lister, American Public Health Association, 202-777-2513 if you have any questions. Thank you for your consideration of this serious matter.

Sincerely,

American Public Health Association
Council of State and Territorial Epidemiologists
National Association of County and City Health Officials
Society for Public Health Education