加利福尼亚州未成年人医疗同意和保密法
CALIFORNIA MINOR CONSENT AND CONFIDENTIALITY LAWS
| 任何年纪的未成年 可以同意 | 法规、细则 | 医疗提供者是否 可以/必须 通知其家长该医治或披露相关医疗信息？ |
|---|---|---|
| 怀孕 | 未成年人可以同意接与避孕或治疗妊娠有关的医疗服务，而绝育除外。（家庭法§ 6925） | 不允许医疗保健提供者在未经未成年人同意的情况下通知家长或其法定监护人。提供者仅可以在以下前提与他们分享未成年人的医疗信息：未成年人签署授权书。（健康和安全法§§ 123110(a), 123115(a)(1); 民法§§ 56.10, 56.11） |
| 避孕 | 未成年人可以在不经家长同意的情况下接受避孕措施。（家庭法§ 6925） | |
| 堕胎 | 未成年人可以同意堕胎而无需其家长的同意。（家庭法§ 6925；以及判例 American Academy of Pediatrics v. Lungren, 16 Cal.4th 307 (1997） | 未经未成年人的同意，医疗保健提供者不得通知其家长或法定监护人。提供者只能在未成年人签名授权下向他们披露未成年人的医疗信息。 （Lungren案判例；健康和安全法§§123110(a), 123115(a)(1)；民法§§ 56.10, 56.11） |
| 性侵的相关救治服务 仅出于未成年人同意医疗保健的目的，此处所列性侵包括口交，鸡奸，和其他类型性犯罪。 | 【可能】曾遭受过性侵的未成年可以同意接受医疗保健相关的诊断，治疗和收集与之相关的医疗证据。（家庭法§ 6928） | 医疗保健提供者必须尝试与未成年人的家长/监护人联系，并在未成年人病历中记录尝试联系的日期和时间，以及是否联系成功。如果治疗专家合理地认为其家长/监护人实施了侵犯，则该规定不适用。（家庭法§ 6928） 根据加州法律，对未成年人的强奸和性侵犯都被视为虐待儿童，包括医疗健康提供者在内的授权吹哨人必须举报此类行径。提供者不能在未经青少年同意的情况下向其家长透露他们已提交此报告。但是，应告知青少年患者，调查该报告的虐待儿童相关机构可能会向其家长披露该举报。（刑法§§ 11165.1, 11165.6, 11166, 11167） |
| 对未满12岁未成年被强奸的相关救治服务 对强奸的定义适用刑法§ 261 请参阅下文的“已满12岁未成年被强奸的相关救治服务” | 可能遭遇强奸的未满12岁未成年人 “可以同意接受医疗与诊断，治疗和收集有关强奸方面的医学证据。“（家庭法§ 6928） |
| MINORS OF ANY AGE MAY CONSENT | LAW/DETAILS | MAY/MUST THE HEALTH CARE PROVIDER INFORM A PARENT ABOUT THIS CARE OR DISCLOSE RELATED MEDICAL INFORMATION TO THEM? |
|---|---|---|
| PREGNANCY | “A minor may consent to medical care related to the prevention or treatment of pregnancy,” except sterilization. (Fam. Code § 6925). | The health care provider is not permitted to inform a parent or legal guardian without the minor’s consent. The provider can only share the minor’s medical information with them with a signed authorization from the minor. (Health & Saf. Code §§ 123110(a), 123115(a)(1); Civ. Code §§ 56.10, 56.11). |
| CONTRACEPTION | A minor may receive birth control without parental consent. (Fam. Code § 6925). | |
| ABORTION | A minor may consent to an abortion without parental consent. (Fam. Code § 6925; American Academy of Pediatrics v. Lungren,16 Cal.4th 307 (1997)). | The health care provider is not permitted to inform a parent or legal guardian without the minor’s consent. The provider can only share the minor’s medical information with them with a signed authorization from the minor. (American Academy of Pediatrics v. Lungren, 16 Cal.4th 307 (1997); Health & Safety Code §§ 123110(a), 123115(a)(1); Civ. Code §§ 56.10, 56.11). |
| SEXUAL ASSAULT1 SERVICES 1For the purposes of minor consent health care alone, sexual assault includes acts of oral copulation, sodomy, and other crimes of a sexual nature. | “A minor who [may] have been sexually assaulted may consent to medical care related to the diagnosis, treatment and the collection of medical evidence with regard to the …assault.” (Fam. Code § 6928). | The health care provider must attempt to contact the minor’s parent/guardian and note in the minor’s record the day and time of the attempted contact and whether it was successful. This provision does not apply if the treating professional reasonably believes that the parent/guardian committed the assault. (Fam. Code § 6928). Both rape and sexual assault of a minor are considered child abuse under California law and mandated reporters, including health providers, must report it as such. Providers cannot disclose to parents that they have made this report without the adolescent’s authorization. However, adolescent patients should be advised that the child abuse authorities investigating the report may disclose to parents that a report was made. (See Pen. Code §§ 11165.1, 11165.6, 11166, 11167.) |
| RAPE2 SERVICES FOR MINORS UNDER 12 YRS3 2Rape is defined in Penal Code § 261. 3See also “Rape Services for Minors 12 and Over” on page 3 of this chart | A minor under 12 years of age who may have been raped “may consent to medical care related to the diagnosis,…treatment and the collection of medical evidence with regard” to the rape. (Fam. Code § 6928). |
| 任何年纪的未成年 可以同意 | 法规、细则 | 医疗提供者是否 可以/必须 通知其家长该医治或披露相关医疗信息？ |
|---|---|---|
| 紧急医疗服务* *紧急情况是指“需要立即提供服务以减轻严重疼痛或立即诊断出未预见的医疗状况，如果不立即诊断和治疗，将导致严重的残疾甚至死亡”后果（业务和专业守则§ 2397(c)(2)） | 如果提供者“合理地认为[该]程序应立即进行并且没有足够的时间获得[家长]的知情同意，则提供者不应对未成年人执行此程序负责。（业务和专业守则§ 2397(c)(2)） | 其家长或监护人通常有权检查未成年人的记录。（健康和安全法§§ 123110(a)；民法§§ 56.10, 56.11）但请留意尾注（exc）部分） |
| 骨骼光射线诊断虐待儿童或过失侵权* *提供者不需要未成年人或其家长的同意即可执行本节中的程序。 | “医师，外科医生或牙医或其代理人可以不经未成年家长或监护人同意而对其进行骨骼光检查，但仅为可能存在的虐待或儿童或过失侵权的案件诊断并确定其程度为目的。”（刑法§ 11171.2） | 根据本法规所报告的信息，在任何法院程序中医患特权和心理治疗师特权均不适用。 |
| MINORS OF ANY AGE MAY CONSENT | LAW/DETAILS | MAY/MUST THE HEALTH CARE PROVIDER INFORM A PARENT ABOUT THIS CARE OR DISCLOSE RELATED MEDICAL INFORMATION TO THEM? |
|---|---|---|
| EMERGENCY MEDICAL SERVICES* *An emergency is “a situation . . . requiring immediate services for alleviation of severe pain or immediate diagnosis of unforeseeable medical conditions, which, if not immediately diagnosed and treated, would lead to serious disability or death” (Bus. & Prof. § 2397(c)(2)). *An emergency is “a situation . . . requiring immediate services for alleviation of severe pain or immediate diagnosis of unforeseeable medical conditions, which, if not immediately diagnosed and treated, would lead to serious disability or death” (Bus. & Prof. § 2397(c)(2)). | A provider shall not be liable for performing a procedure on a minor if the provider “reasonably believed that [the] procedure should be undertaken immediately and that there was insufficient time to obtain [parental] informed consent.” (Bus. & Prof. Code § 2397). | The parent or guardian usually has a right to inspect the minor’s records. (Health & Saf. Code §§ 123110(a); Civ. Code § 56.10. But see exception at endnote (EXC.)). |
| SKELETAL X-RAY TO DIAGNOSE CHILD ABUSE OR NEGLECT* * The provider does not need the minor’s or parent’s consent to perform a procedure under this section. | “A physician and surgeon or dentist or their agents . . . may take skeletal X-rays of the child without the consent of the child's parent or guardian, but only for purposes of diagnosing the case as one of possible child abuse or neglect and determining the extent of.” (Penal Code § 11171.2). | Neither the physician-patient privilege nor the psychotherapist patient privilege applies to information reported pursuant to this law in any court proceeding. |
| 已满12岁的未成年可以同意 | 法规、细则 | 医疗提供者是否 可以/必须 通知其家长该医治或披露相关医疗信息？ |
|---|---|---|
| 传染病（诊断，治疗） | “未满12岁且可能已与传染性疾病接触过的未成年人，如果该疾病是法律要求报告的。可以同意接受治疗诊断。”（家庭法§ 6926） | 不经未成年人的同意，医疗保健提供者不得通知其家长或法定监护人。提供者只能在未成年人签名的授权后向他们披露未成年人的医疗信息。（健康和安全法§§ 123110(a), 123115(a)(1); 民法§§ 56.10, 56.11） |
| 性传播疾病（预防护理，诊断，治疗） | 可能接触过性传播疾病的已满12岁的未成年人可以同意接受与该疾病的诊断或治疗有关的医疗护理。 已满12岁的未成年人也可以同意与预防性传播疾病有关的医疗服务（家庭法§ 6926） |
| MINORS 12 YEARS OF AGE OR OLDER MAY CONSENT | LAW/DETAILS | MAY/MUST THE HEALTH CARE PROVIDER INFORM A PARENT ABOUT THIS CARE OR DISCLOSE RELATED MEDICAL INFORMATION TO THEM? |
|---|---|---|
| INFECTIOUS, CONTAGIOUS COMMUNICABLE DISEASES (DIAGNOSIS, TREATMENT) | “A minor who is 12 years of age or older and who may have come into contact with an infectious, contagious, or communicable disease may consent to medical care related to the diagnosis or treatment of the disease, if the disease… is one that is required by law…to be reported….” (Fam. Code § 6926). | The health care provider is not permitted to inform a parent or legal guardian without the minor’s consent. The provider can only share the minor’s medical information with them with a signed authorization from the minor. (Health & Saf. Code §§ 123110(a), 123115(a)(1); Civ. Code §§ 56.10, 56.11). |
| SEXUALLY TRANSMITTED DISEASES (PREVENTIVE CARE, DIAGNOSIS, TREATMENT) | A minor 12 years of age or older who may have come into contact with a sexually transmitted disease may consent to medical care related to the diagnosis or treatment of the disease. A minor who is 12 years of age or older may also consent to medical care related to the prevention of a sexually transmitted disease. (Fam. Code § 6926). |
| 已满12岁的未成年可以同意 | 法规、细则 | 医疗提供者是否 可以/必须 通知其家长该医治或披露相关医疗信息？ |
|---|---|---|
| 艾滋病（预防措施，测试，诊断和治疗） | 已满12岁的未成年人有能力对艾滋病检测提供书面同意。 （加州健康与安全法 §121020）。已满12岁的未成年人可以同意接受预防，诊断和治疗HIV / AIDS有关的医疗服务。 （民法§6926）。当前可用的服务包括暴露前和暴露后的预防药物，以预防HIV感染（PrEP和PEP）。 | 未经未成年人的同意，医疗保健提供者不得通知其家长或法定监护人。提供者只能在未成年人签名的授权下向他们披露未成年人的医疗信息。（健康与安全法§§ 123110(a), 123115(a)(1); 民法§§ 56.10, 56.11） |
| 已满12岁未成年被强奸的相关救治服务 | “声称被强奸的已满12岁的未成年人可以同意接受与病情诊断或治疗有关的医疗护理，并就被指控的强奸行为收集医学证据。（家庭法§ 6927） | 未经未成年人的同意，医疗保健提供者不得通知其家长或法定监护人。提供者只能在未成年人签名的授权下向他们披露未成年人的医疗信息。（健康与安全法§§ 123110(a), 123115(a)(1); 民法§§ 56.10, 56.11） 根据加州法律，对未成年人的强奸被视为虐待儿童，包括医疗健康提供者在内的授权吹哨人必须举报此类行径。提供者不能在未经青少年批准的情况下向其家长透露他们已提交此报告。但是，应告知青少年患者，调查该报告的虐待儿童相关机构可能会向其家长披露该举报。。（刑法§§ 11165.1, 11165.6, 11166, 11167） |
| 亲密伴侣暴力* *仅出于未成年人同意的医疗保健目的 “亲密伴侣暴力”就意味着故意或不顾后果地造成人身伤害，由与该未成年人保持性关系，约会或配偶关系的人所实施的。如果未成年人因强奸或性侵犯而寻求服务，未成年人同意的救治服务应受相关“性侵犯”或“强奸”同意法律约束，而不是本法。（家庭法§6930(b)） | “未满12岁且声称由于亲密伴侣的暴力行为而受伤的未成年人，可以同意接受与伤口的诊断或治疗有关的医疗护理，并同意收集有关亲密伴侣暴力所致医疗证据。”（家庭法§ 6930） | 多数情况下，未成年人亲密伴侣暴力将被视为符合虐待儿童举报条件，包括医疗健康提供者在内的授权吹哨人必须举报此类行径。（刑法§§ 11165.6, 11166, 11167） 未经未成年人的同意，医疗保健提供者不得通知其家长或法定监护人。提供者只能在未成年人签名的授权下向他们披露未成年人的医疗信息。（健康与安全法§§ 123110(a), 123115(a)(1); 民法§§ 56.10, 56.11） 如果不需要举报虐待儿童的情况（例如，伤害是由“未成年人之间的相互骚扰”引起的），则可以按《刑法》第11160条（枪支，攻击性或虐待性行为造成的伤害）的情况报告。 如果根据《刑法》第11160条进行了报告，则健康提供者应执行以下两项操作： 1）告知未成年人将作出报告，并且 2）尝试与未成年人的家长或监护人联系，并将此报告告知他们。医务人员应在未成年人的治疗记录中注明尝试与其家长或监护人联系的日期和时间，以及尝试是否成功。如果医疗人员合理地认为未成年人的其家长或监护人造成了枪伤或可疑伤害，则此通知要求不适用。（家庭法 § 6930(c)).） 注意：当看起来好像可以根据虐待儿童举报法或刑第 11160条举报伤害时，举报人必须将其按虐待儿童举报法规执行，而不是刑法 第11160条。（刑法 第11162.7条）。提供者应与其法律顾问讨论这些报告法律的适用以及交复影响。 |
| MINORS 12 YEARS OF AGE OR OLDER MAY CONSENT | LAW/DETAILS | MAY/MUST THE HEALTH CARE PROVIDER INFORM A PARENT ABOUT THIS CARE OR DISCLOSE RELATED MEDICAL INFORMATION TO THEM? |
|---|---|---|
| AIDS/HIV (PREVENTIVECARE, TESTING, DIAGNOSIS, AND TREATMENT) | A minor 12 and older is competent to give written consent for an HIV test. (Cal. Health and Safety Code § 121020). A minor 12 and older may consent to medical care related to the prevention, diagnosis and treatment of HIV/AIDS. (Fam. Code § 6926). Services currently available include pre- and postexposure prophylaxis medication to prevent HIV infection (PrEP and PEP). | The health care provider is not permitted to inform a parent or legal guardian without the minor’s consent. The provider can only share the minor’s medical information with them with a signed authorization from the minor. (Health & Saf. Code §§ 123110(a), 123115(a)(1); Civ. Code §§ 56.10, 56.11). |
| RAPE SERVICES FOR MINORS 12 and OVER | “A minor who is 12 years of age or older and who is alleged to have been raped may consent to medical care related to the diagnosis or treatment of the condition and the collection of medical evidence with regard to the alleged rape.” (Fam. Code § 6927). | The health care provider is not permitted to inform a parent or legal guardian without the minor’s consent. The provider can only share the minor’s medical information with them with a signed authorization from the minor. (Health & Saf. Code §§ 123110(a), 123115(a)(1); Civ. Code §§ 56.10, 56.11). Rape of a minor is considered child abuse under California law and mandated reporters, including health care providers, must report it as such. Providers cannot disclose to parents that they have made this report without the adolescent’s authorization. However, adolescent patients should be advised that the child abuse authorities investigating the report may disclose to parents that a report was made. (See Pen. Code §§ 11165.1, 11165.6, 11166, 11167.) |
| INTIMATE PARTNER VIOLENCE* *For the purposes of minor consent health care alone, “'intimate partner violence’ means an intentional or reckless infliction of bodily harm that is perpetrated by a person with whom the minor has or has had a sexual, dating, or spousal relationship.” If the minor is seeking services as a result of a rape or sexual assault, minor consent services should be provided under the “sexual assault” or “rape” minor consent laws rather than this law. (Fam. Code §6930(b)). | “A minor who is 12 years of age or older and who states he or she is injured as a result of intimate partner violence may consent to medical care related to the diagnosis or treatment of the injury and the collection of medical evidence with regard to the alleged intimate partner violence.” (Fam. Code § 6930). | In most cases, intimate partner violence as defined in this statute will meet the definition of child abuse for reporting purposes and mandated reporters must report it as such. (Pen. Code §§ 11165.6, 11166, 11167.). In those cases, the health care provider is not permitted to disclose information to a parent or legal guardian without the minor’s authorization. The provider can only share that information with a signed authorization from the minor. (Health & Saf. Code §§ 123110(a), 123115(a)(1); Civ. Code §§ 56.10, 56.11). In cases where a child abuse report is not required (e.g., where the injury was caused by a "mutual affray between minors"), a report under Penal Code 11160 (injuries caused by firearms or assaultive or abusive conduct) may be mandated. If a report under Penal Code 11160 is made, the health provider shall do both of the following: 1) inform the minor that the report will be made, and 2) attempt to contact the minor’s parent or guardian and inform them of the report. The health practitioner shall note in the minor’s treatment record the date and time of the attempt to contact the parent or guardian, and whether the attempt was successful or unsuccessful. This notification requirement does not apply if the health practitioner reasonably believes that the minor’s parent or guardian inflicted the gunshot or suspicious injury. (Fam. Code § 6930(c)). Note: When an injury appears as if it could be reported under either child abuse reporting law or Penal Code 11160, the reporter must report it as child abuse rather than under Penal Code 11160. (Pen. Code § 11162.7.) Providers should discuss the application and intersection of these reporting laws with their legal counsel. |
| 已满12岁的未成年可以同意 | 法规、细则 | 医疗提供者是否 可以/必须 通知其家长该医治或披露相关医疗信息？ |
|---|---|---|
| 门诊心理保健服务/庇护服务 4 本节未授权未成年人未经其同意而接受住院精神病治疗，抽搐治疗，精神外科或精神药物。 | 两项法规赋予未成年人同意接受心理健康治疗的权利。如果未成年人符合任一法规的标准，则未成年人可以同意接受其自己的治疗。如果未成年人同时符合这两个条件，则提供者可以决定适用哪个法规。它们之间有一些区别。有关这些差异的更多信息，请参见尾注** 家庭法§ 6924 “如果满足以下两个条件，则已满12岁的未成年人可以同意接受门诊病人的心理健康治疗或咨询，或同意寄宿庇护服务： （1）主治医生认为，未成年人心智已经足够成熟，可以明智地参与门诊服务或寄宿庇护服务。和 （2）该未成年人（A）如果没有心理健康治疗，咨询或寄宿庇护服务，将对自己或他人造成严重的身体或精神伤害，或者（B）声称为乱伦或虐待儿童的受害者” 健康与安全法§ 124260 “已满12岁的未成年人可以同意参加[门诊]心理健康治疗或咨询服务，如果在职专业人员认为该未成年人足够成熟，可以明智地参加精神健康治疗或咨询服务。” | 心理健康治疗： 医疗保健提供者必须让其家长或监护人参与未成年人的治疗，除非医疗保健提供者认为这种参与是不适当的。此决定以及与其家长的任何联系尝试都必须记录在未成年人的病历中。（家庭法§ 6924; 45 C.F.R. 164.502(g)(3)(ii).)） 对于根据《健康与安全法》第124260条要求提供的服务，提供者在决定是否让其家长参与之前必须征询未成年人。 尽管此例外允许提供者在适当的时候通知其家长并让他们参与治疗，但它没有赋予提供者未经未成年人授权就向其家长披露病历的权利。提供者只能在未成年人签名授权后才能向其家长披露未成年人的病历。 （健康与安全法§§ 123110(a), 123115(a)(1）；民法；§§ 56.10, 56.11, 56.30；福利和机构守则§ 5328。请参阅尾注（exc）) 庇护所：尽管未成年人可能同意服务，但庇护所必须根据未成年人所提供的信息尽最大努力将服务内容通知其家长/监护人。 （家庭法§ 6924） |
| MINORS 12 YEARS OF AGE OR OLDER MAY CONSENT | LAW/DETAILS | MAY/MUST THE HEALTH CARE PROVIDER INFORM A PARENT ABOUT THIS CARE OR DISCLOSE RELATED MEDICAL INFORMATION TO THEM? |
|---|---|---|
| OUTPATIENT MENTAL HEALTH SERVICES4/ SHELTER SERVICES 4This section does not authorize a minor to receive inpatient psychiatric care, convulsive therapy, psychosurgery or psychotropic drugs on their own consent. | Two statutes give minors the right to consent to mental health treatment. If a minor meets the criteria under either statute, the minor may consent to his or her own treatment. If the minor meets the criteria under both, the provider may decide which statute to apply. There are differences between them. See endnote ** for more on these differences: Family Code § 6924 “A minor who is 12 years of age or older may consent to mental health treatment or counseling on an outpatient basis or to residential shelter services, if both of the following requirements are satisfied: (1) The minor, in the opinion of the attending professional person, is mature enough to participate intelligently in the outpatient services or residential shelter services. AND (2) The minor (A) would present a danger of serious physical or mental harm to self or to others without the mental health treatment or counseling or residential shelter services, or (B) is the alleged victim of incest or child abuse.” (Fam. Code § 6924.) Health & Safety Code § 124260 “[A] minor who is 12 years of age or older may consent to [outpatient] mental health treatment or counseling services if, in the opinion of the attending professional person, the minor is mature enough to participate intelligently in the mental health treatment or counseling services.” (Health & Saf. Code § 124260.) | MENTAL HEALTH TREATMENT: The health care provider is required to involve a parent or guardian in the minor’s treatment unless the health care provider decides that such involvement is inappropriate. This decision and any attempts to contact parents must be documented in the minor’s record. (Fam. Code § 6924; 45 C.F.R. 164.502(g)(3)(ii).) For services provided under Health and Safety Code § 124260, providers must consult with the minor before deciding whether to involve parents. (Health & Saf. Code § 124260(a).) While this exception allows providers to inform and involve parents in treatment when appropriate, it does not give providers a right to disclose medical records to parents without the minor’s authorization. The provider can only share the minor’s medical records with parents with a signed authorization from the minor. (Health & Saf. Code §§ 123110(a), 123115(a)(1); Civ. Code §§ 56.10, 56.11, 56.30; Welf. & Inst. Code § 5328. See also endnote(EXC).) SHELTER: Although minor may consent to service, the shelter must use its best efforts based on information provided by the minor to notify parent/guardian of the provision of services. (Fam. Code § 6924.) |
| 已满12岁的未成年可以同意 | 法规、细则 | 医疗提供者是否 可以/必须 通知其家长该医治或披露相关医疗信息？ |
|---|---|---|
| 药物或酒精滥用治疗 •本节未授权未成年人在未经其家长或监护人同意的前提下，而接受替代麻醉品治疗。 •在其家长或监护人同意进行治疗的情况下，本节未授予未成年人拒绝就药物或酒精相关问题进行医疗和咨询的权利。 （家庭法 第6929（f）条）。 •家庭法第§6929(a)(2)条定义了“毒品或酒精”和“咨询”一词 | 已满12岁的未成年人可以同意就有关毒品或酒精相关问题的诊断和治疗进行医疗护理和咨询。（家庭法§6929(b)） | 联邦和州法律有着不同的保密规则。符合以下“联邦”中列出的条件的提供者必须遵守联邦法规。不符合这些条件的提供者则需要遵守州法律。 联邦：联邦保密法适用于符合以下两个条件的任何个人，项目或机构： 1.个人，项目或机构得到联邦政府的协助。 （联邦协助是指全部或部分由联邦政府的任何部门授权，认证，许可，支持或资助的。譬如：联邦，州或地方计划包括：免税；接受可抵税的捐款；接受任何联邦政府的运作资金，无论是否直接用于防治药物滥用计划；或已在注册）（联邦政府第42号法规§2.12） 以及 2. 个人或项目： 1）认为自身维系，并提供了药物使用障碍的诊断，治疗或转诊治疗的个人或实体（一般医疗机构除外）；或 2）普通医疗机构中已确定的单元，该单元维系并提供药物使用障碍的诊断，治疗或转诊治疗；或 3）普通医疗机构中主要职能是提供物质使用失常的诊断，治疗或转诊治疗的医务人员或其他人员，并被确定为提供者（联邦政府第42号法规§2.11及§2.12） 对于符合这些条件的个人或项目，联邦法律禁止在未得到未成年人书面同意的情况下向其家长披露任何信息。但是，有一个例外，如果项目主管确定该未成年服务申请者 1）由于非常年幼，极端的精神或身体状况而无法做出理性决定是否同意接受某项服务的能力，则允许将相关事实传达给家长。及 2）对未成年人或他人的生命或身体健康构成重大威胁，向其家长披露相关事实可以减轻这种威胁。（联邦政府第42号法规§2.14） 州法规：如上所述，针对家庭法 第6924条提供的“门诊心理健康服务”的相对应保密规则。(家庭法§ 6924) 请参阅尾注（exc） |
| MINORS 12 YEARS OF AGE OR OLDER MAY CONSENT | LAW/DETAILS | MAY/MUST THE HEALTH CARE PROVIDER INFORM A PARENT ABOUT THIS CARE OR DISCLOSE RELATED MEDICAL INFORMATION TO THEM? |
|---|---|---|
| DRUG OR ALCOHOL ABUSE TREATMENT • This section does not authorize a minor to receive replacement narcotic abuse treatment without the consent of the minor's parent or guardian. • This section does not grant a minor the right to refuse medical care and counseling for a drug or alcohol related problem when the minor’s parent or guardian consents for that treatment. (Fam. Code § 6929(f)). • The terms “drug or alcohol” and “counseling” are defined in Fam. Code § 6929(a)(2). | “A minor who is 12 years of age or older may consent to medical care and counseling relating to the diagnosis and treatment of a drug or alcohol related problem.” (Fam. Code §6929(b)). | There are different confidentiality rules under federal and state law. Providers meeting the criteria listed under ‘federal’ below must follow the federal rule. Providers that don’t meet these criteria follow state law. FEDERAL: Federal confidentiality law applies to any individual, program, or facility that meets the following two criteria: 1. The individual, program, or facility is federally assisted. (Federally assisted means authorized, certified, licensed, supported or funded in whole or in part by any department of the federal government. Examples include federal, state or local programs that are: tax exempt; receiving tax-deductible donations; receiving any federal operating funds whether used directly for the substance use disorder program or not; or registered with Medicare) (42 C.F.R. §2.12); AND 2. The individual or program is: 1) An individual or entity (other than a general medical facility) who holds itself out as providing, and provides, substance use disorder diagnosis, treatment, or referral for treatment; or 2) An identified unit within a general medical facility that holds itself out as providing, and provides, substance use disorder diagnosis, treatment, or referral for treatment; or 3) Medical personnel or other staff in a general medical facility whose primary function is the provision of substance use disorder diagnosis, treatment, or referral for treatment and who are identified as such providers. (42 C.F.R. §2.11; 42 C.F.R. §2.12). For individuals or programs meeting these criteria, federal law prohibits disclosing any information to parents without a minor’s written consent. There is an exception, however, permitting the communication of relevant facts to the parents if the program director determines that a minor applicant for services 1) lacks capacity because of extreme youth or mental or physical condition to make a rational decision whether to consent to a disclosure to the parents AND 2) there is a substantial threat to the life or physical well-being of the minor applicant or another individual, and the disclosure of relevant facts to the parents may reduce that threat. (42 C.F.R. §2.14). STATE RULE: Parallels confidentiality rule for “Outpatient Mental Health Services” provided under Family Code 6924, as described above. (Fam. Code §6929(c).) See also exception at endnote (EXC). |
| 已满15岁的未成年 | 法规、细则 | 医疗提供者是否 可以/必须 通知其家长该医治或披露相关医疗信息？ |
|---|---|---|
| 通用医疗保险 | “如果满足以下所有条件，则未成年人可以同意接受未成年人的医疗或牙科护理：（1）未成年人年龄已满15岁。 （2）未成年人与其家长或监护人分开居住，无论是否经过其家长或监护人的同意，并且与单独居住的时长无关。 （3）无论未成年人的收入来源如何，都在管理自身的收入。” （家庭法 § 6922(a).） | “如果未成年人患者同意，医师和外科医生或牙医可根据未成年人所提供的信息和监护人所在之处，向其家长或监护人告知所给予的或将需要的治疗。”（家庭法§ 6922(c)。请参阅尾注（exc）） |
| MINORS 15 YEARS OF AGE OR OLDER | LAW/DETAILS | MAY/MUST THE HEALTH CARE PROVIDER INFORM A PARENT ABOUT THIS CARE OR DISCLOSE RELATED MEDICAL INFORMATION TO THEM? |
|---|---|---|
| GENERAL MEDICAL CARE | “A minor may consent to the minor's medical care or dental care if all of the following conditions are satisfied: (1) The minor is 15 years of age or older. (2) The minor is living separate and apart from the minor's parents or guardian, whether with or without the consent of a parent or guardian and regardless of the duration of the separate residence. (3) The minor is managing the minor's own financial affairs, regardless of the source of the minor's income.” (Fam. Code § 6922(a).) | “A physician and surgeon or dentist may, with or without the consent of the minor patient, advise the minor's parent or guardian of the treatment given or needed if the physician and surgeon or dentist has reason to know, on the basis of the information given by the minor, the whereabouts of the parent or guardian.” (Fam. Code § 6922(c). See also exception at endnote (EXC)). |
| 未成年人必须获得自由 (一般为14岁或以上) | 法规、细则 | 医疗提供者是否 可以/必须 通知其家长该医治或披露相关医疗信息？ |
|---|---|---|
| 通用医疗独立生活的未成年人 | 独立生活的未成年人可以同意接受医疗牙科或心理治疗。 （家庭法§ 7050(e)。关于“独立生活”的定义解析可以参见 家庭法§ 7002） | 未经未成年人同意，医疗保健提供者不得通知其家长或法定监护人。提供者只能在未成年人签名的授权下向他们披露未成年人的医疗信息。 （健康与安全法§§ 123110(a), 123115(a)(1）；民法；§§ 56.10, 56.11) |
| MINOR MUST BE EMANCIPATED (GENERALLY 14 YEARS OF AGE OR OLDER) | LAW/DETAILS | MAY/MUST THE HEALTH CARE PROVIDER INFORM A PARENT ABOUT THIS CARE OR DISCLOSE RELATED MEDICAL INFORMATION TO THEM? |
|---|---|---|
| GENERAL MEDICAL CARE for EMANCIPATED YOUTH | An emancipated minor may consent to medical, dental and psychiatric care. (Fam. Code § 7050(e). See Fam. Code § 7002 for emancipation criteria.) | The health care provider is not permitted to inform a parent or legal guardian without minor’s consent. The provider can only share the minor’s medical information with them with a signed authorization from the minor. (Health & Saf. Code §§ 123110(a), 123115(a)(1); Civ. Code §§ 56.10, 56.11). |
如果标明出处，则可以复制此图表以供个人使用。
*保密和同意法律法规有许多。不同的规则适用于不同的情形。本图表说明了未成年人与其家长或监护人同住时适用的规则。它未解决未成年人在法院司法体系下或处于其他特殊生活状况时所适用的规则。此外，机密性部分重点关注家长和提供者的权限。它没有解释其他人或机构何时有权获取机密信息的问题。此图表仅提供法律信息，而并非法律建议。提供者应与他们自己的法律顾问探讨相关法律建议。
This chart may be reproduced for individual use if accompanied by an acknowledgement.
* There are many confidentiality and consent rules. Different rules apply in different contexts. This chart addresses the rules that apply when minors live with their parents or guardians. It does not address the rules that apply when minors are under court jurisdiction or in other special living situations. Further, the confidentiality section focuses on parent and provider access. It does not address when other people or agencies may have a right to access otherwise confidential information. This chart provides legal information, not advice. Providers are encouraged to speak to their own legal counsel for advice on application of these laws.
**除了资格标准略有不同外，《健康与安全法》第124260条和《家庭法》第6924条也有一些细微差别。例如，两项法律均允许“专业人士”提供未成年人同意服务，但两项法律对“专业人士”的定义有所不同。另外，有一项资金限制适用于健康和安全法规§124260，但不适用于家庭法规§6924。（参阅家庭法§ 6924，健康与安全法§124260和福利和机构守则§14029； 获取更多信息请参阅www.teenhealthlaw.org）
** In addition to having slightly different eligibility criteria, there are other small differences between Health and Safety Code §124260 and Family Code § 6924. For example, the two laws both allow “professional persons” to deliver minor consent services but the two laws define “professional person” differently. Also, there is a funding restriction that applies to Health and Safety Code §124260 but not to Family Code § 6924. (See Fam. Code § 6924, Health & Saf. Code § 124260 and Welf. & Inst. Code §14029.8 and look for more information on www.teenhealthlaw.org.).
EXC: 如果医疗保健提供者确定“对提供者与未成年人患者的专业关系或未成年人的身体安全或心理健康的影响，对[其家长或监护人]要求查询的患者信息，则提供者可以拒绝向未成年人家长提供病历，虽然通常情况下其家长有权获得这些信息。”健康与安全法§123115(a)(2)。对所作出获取未成年人记录有关的任何诚信决定，提供者不承担负责。同上。
EXC: Providers may refuse to provide parents access to a minor’s medical records, where a parent normally has a right to them, if “the health care provider determines that access to the patient records requested by the [parent or guardian] would have a detrimental effect on the provider’s professional relationship with the minor patient or the minor’s physical safety or psychological well-being.” Health & Saf. Code § 123115(a)(2). A provider shall not be liable for any good faith decisions concerning access to a minor’s records. Id.
Reference:
https://www.altamed.org/sites/default/files/2019CaMinorConsentConfChartFull.pdf
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