Can a pregnant teenager in North Carolina give legal consent on her own for a sickle cell test as part of her prenatal care, or does she need a parent's permission first?

Plain-English summary

The Attorney General concluded that G.S. 90-21.5 lets a minor consent to sickle cell testing when the test is part of medical treatment for the minor's pregnancy. The opinion says pregnancy is a condition for which a minor may consent and that sickle cell testing is necessary for proper medical management of pregnancy. G.S. 90-21.2 defines “treatment” to include “laboratory or other diagnostic procedures,” which covers the testing discussed.

The opinion distinguishes an earlier Attorney General opinion about genetic counseling. That earlier conclusion rested on counseling falling outside the four consent categories in G.S. 90-21.5 and outside the statutory definition of “treatment.” The 1984 opinion applies the pregnancy category and the diagnostic-procedure definition to testing. It does not extend its consent conclusion to genetic counseling or case management.

Currency note

This opinion applies the minor-consent provisions quoted in 1984. Check current North Carolina law for a present consent question.

Historical context: what the AG concluded

The earlier opinion, cited as 49 N.C.A.G. 181, said providing genetic counseling without parental consent could conflict with common-law principles governing the parent-child relationship. The 1984 opinion explains why sickle cell testing as part of pregnancy treatment is different: pregnancy falls within G.S. 90-21.5, and a laboratory or diagnostic procedure falls within “treatment” under G.S. 90-21.2.

The conclusion is specific: a minor may give effective consent “for the performance of sickle cell testing as part of the medical treatment of the minor's pregnancy.” The opinion does not discuss counseling that might accompany the test.

Background and statutory framework

G.S. 90-21.5 identifies categories for which a minor may consent, including pregnancy. G.S. 90-21.2 includes laboratory and other diagnostic procedures within the term “treatment.” The Attorney General combines those two provisions to answer the sickle cell testing question. The opinion does not list the other consent categories or discuss parental notice, confidentiality, or a parent's later objection.

Common questions

May a pregnant minor consent to sickle cell testing that is part of pregnancy care?

Yes. The opinion says G.S. 90-21.5 authorizes the minor's consent when the test is part of medical treatment of the pregnancy.

Why does the opinion treat the test differently from genetic counseling?

It says sickle cell testing is a laboratory or diagnostic procedure included in “treatment” under G.S. 90-21.2. The earlier opinion said counseling was outside that definition and outside the covered consent categories it considered.

Does this opinion authorize a minor to consent to genetic counseling or case management?

It does not decide that. Its conclusion covers the performance of sickle cell testing as part of pregnancy treatment. It repeats the earlier opinion's narrower treatment of counseling and says nothing about case management.

What if the test is unrelated to pregnancy?

The opinion does not answer that question. Its reasoning and conclusion expressly rely on the test being part of medical treatment of the minor's pregnancy.

Source

• Landing page: https://ncdoj.gov/opinions/health-consent-for-sickle-cell-testing-by-a-minor/

Citations

• N.C.G.S. § 90-21.2
• N.C.G.S. § 90-21.5
• 49 N.C.A.G. 181 (May 21, 1980)

Original opinion text

Subject:

Requested By:

Conclusion:

A prior opinion of this Office to Dr. Sarah T. Morrow, dated May 21, 1980 (49 N.C.A.G. 181), concluded that "(to) provide genetic counseling to minors without (parental) consent would appear to be a violation of the common law principles governing the parent-child relationship and thus would leave the individual providing these services potentially vulnerable to the litigation." (Emphasis supplied) The conclusion was premised upon (i) the absence of genetic counseling from the four categories for which a minor may give effective consent under G.S. 90-21.5 and (ii) the failure of the definition in G.S. 90-21.2 to include counseling within the term "treatment."

In the present case, pregnancy is included within the conditions for which a minor may consent. Since sickle cell testing is necessary for the proper medical management of pregnancy, a minor may consent to such testing as part of the health services received for the pregnancy. Furthermore, in the present case, "laboratory or other diagnostic procedures," such as sickle cell testing, is included within the term "treatment" under G.S. 90-21.2.

Therefore, it is the opinion of this Office that G.S. 90-21.5 authorizes a minor to give effective consent for the performance of sickle cell testing as part of the medical treatment of the minor's pregnancy.

RUFUS L. EDMISTEN
Attorney General

Robert R. Reilly
Assistant Attorney General