In Fairfield, Maine, Eric Sack father discovered a plastic baggie containing doses of prescription anti-depressants in the possession of his daughter. His daughter told him that the pills had been provided to her by the Bulldog Health Center, a School Based Health Center (SBHC) at Lawrence High School, where she is a student.
Yeah, right. I thought she was lying too, but the daughter wasn’t wasn’t. The federally funded health clinic that operates within the school gave the pills to her without his knowledge or consent.
How could this happen?
Sack regards the distribution of the pills an infringement on his parental rights, which it was. He also found it unacceptable that the school’s clinic sent unlabeled drugs with no child-resistant container into his home, where his daughter has two younger siblings. Lawrence High School Principal Dan Bowers, however, responded to his to complaint about unauthorized drug treatments being given to a minor without parental notice of consent, Bowers denied that his school had any responsibility in the matter because the SBHC was a separate entity from the school and not under his control.
He told the father than he should be grateful since at least she wasn’t being given testosterone shots so she could start winning track meets. (OK, I was just kidding about that part.)
Ethics Alarms 
I’m sure the CPS call wasn’t as bad either… Parents just need to get in line. Why won’t won’t these grubs figure that out?
Wait, why do I have to log in with my full name now?
I have no idea. You do? It’s not me, I swear. See, I fixed it for you!
WordPress has a new comment setup. My Other Bill seems to have disappeared and Old Bill is now in play. Fine by me, just a little strange.
The story gets worse. Read farther down at the third link above — gave the pills to her &ff. How about a suspicion of child abuse and a visit from DHS?
But, farther yet down the article, it appears the parents may have signed a consent form. Did they give permission for this kind of thing unknowingly (and carelessly)?
Was the principal right that he has no control over the clinic?
It appears there is something rotten in the state of Maine, but there are some loose ends to this story. Maybe someone else will dig; I’m traveling and shouldn’t be reading or commenting on complicated issues.
I knew I should have let this go and quit thinking and (for sure) quit talking about it.
But — a close and dear relative who is a school nurse has informed me that, in her state, this would be perfectly legal (aside from that incompetent packaging of the meds). Further, she said, the age of consent for medical treatment can be as low as 13, depending on the state.
So, did the student (17 years old) consent? Don’t know.
Did the clinic act in accordance with the law? Seems it might have.
If the clinic should violate the law, under what circumstances would it be ethical to do that, and do those circumstances apply here? Unknown.
Are there situations where parental prerogatives for raising kids should be overridden? Well, yes, there are incompetent and evil parents. Doesn’t seem that either evil or incompetence applies here, but, how would the clinic verify that? Or, should they have delayed until CPS did a home visit?
So, to repeat, there are a few loose ends here.
And, what does anything in this story have to do with trust or distrust of public school teachers? Guilt by association twice removed?
Not one bit of this would change the post. I supposed this post should have just used “schools” rather than “teachers” in the title, though teachers are the intermediaries in all matters involving student welfare. Do you think the clinic was pulling kids out of class and subjecting them to psychological examinations and medical treatment without a teacher’s referral? I suppose the girl might have gone on her own to the clinic, which, being in the school, is part of the school, and the teacher was completely uninvolved. I doubt it, but for the sake of clarity, I’ll take “teachers” out and leave “schools” in the headline. There: done.
The post has everything to do with distrust of schools, school administrators, the regulations of schools, and the public school system as well as school boards. I don’t care if the student consented or not. It’s unethical for a minor to be diagnosed and treated with drugs without parental notice or consent. If a law allows that, the law’s unethical.
1. If a state law permits schools to distribute prescription drugs to minors without parental notice or consent, the law is unethical, and using it to do so is unethical (just because something is permitted and legal doesn’t make it responsible or ethical.)
2. Absent evidence of a crime or neglect, there is no ethical basis for school personnel to challenge or judge a parent’s conduct and methods of child-rearing “cruel or evil.” Who are teachers—there’s that word again—to overrule parents? What’s their expertise or authority? Zoloft, the drug involved, may have been specifically ruled out by the parent’s chosen doctor for their kid. It was the clinic’s job to check, and the school’s job to check, because it was entrusted with the child. (And the baggie is strong evidence that these are irresponsible bailees.)
3. Conduct is ethical or unethical, and laws don’t change a thing, except that it is usually unethical to violate the law. Some states authorize teachers striking students too—that’s unethical, and an ethical teacher/school won’t do it.
Fact: a minor student was given a prescription drug without the parents knowing or consenting, their health provider alerted and consulted, and parental authority being respected. Unethical. No doubt about it, regardless of the “loose end.”
1. Maine law does allow clinics to treat minors for psychological conditions with minor consent and without parental consent (not sure about schools). The law also allows minors to request confidentiality, including from parents. Are there situations where confidential treatment would be appropriate? I say, yes. Is this such a situation? Don’t know. As an aside, the student was 17; the age of consent in Maine is 16.
2. We don’t know what checking was done by the clinic, nor what information they already had. From the article, it does not appear that there was a doctor for the student with whom to check. If so, and if a psychological condition had existed for some time, that would at least imply parental neglect.
3. Doctors have an ethical duty to treat medical conditions, given informed consent.
A sixteen, 17, or 13 year old is incapable of informed consent. Again, Maine’s laws are irrelevant to ethics.
Citation required here, Jack. There is no biological switch that turns on when someone’s 18th birthday rolls around. Minors of sufficient maturity can consent to medical treatments just as seniors of sufficient cognitive decline cannot. It is medical professionals’ jobs to determine whether the patient in front of them has that capacity to consent.
I’m in complete agreement with Here’s Johnny’s analysis.
And that’s a rationalization that the Mary Kay Latoureaus and the Man-Boy Love Association have used for decades. In terms of consent, the law has to draw lines, and outliers are out of luck. The harm in making the unusually mature child wait for the right to consent is far outweighed by the protection of the majority of children who cannot give meaningful consent. Here’s a cite: and the fact is that there is no way to tell with certainty when an individual is “mature,” and in fact, we know that a brain isn’t fully developed until the 20s.
In my main field, legal ethics, the presumption that clients can give informed consent to, for example, a lawyer’s conflict of interest is a convenient myth, and most lawyers admit it. Most clients don’t know what they are consenting to, and those are adults. Minors are notorious for short-time perspective: I’ll stick to the conclusion that assuming any of them should be allowed to consent to medical treatment is reckless and intellectually dishonest.
We’ll have to agree to disagree.
Your citation suggests that brain development continues into a person’s 20s — no disagreement there. What we do with that fact is the issue.
You contend that making a mature child wait to consent is the lesser harm; that is your opinion and that is what requires more support. Modern medical systems have generally moved away from your position.
Again, the arbitrariness of setting an age of majority and the analogous case of losing the capacity to consent with senility (and mental illness) strongly suggest, logically, that capacity to consent needs to be purposefully determined on an ongoing and case-by-case basis. To be clear, there isn’t (or shouldn’t be) any “assuming” that a person is capable of making medical decisions.
I don’t doubt that most people don’t know what they’re consenting to, in law or in medicine. I regularly sign and agree to things without reading, much less understanding, them. Everyone regularly takes medications without reading the insert, much less memorising them in the context of all their other ingestions. These behaviors don’t help guide us on the practicalities of allowing children to take charge of their own healthcare if they show themselves to be capable.
In this specific case, one may question whether this 17-year-old was properly assessed at the clinic and whether the decision to keep parents out of the loop was carefully considered, but barring evidence to the contrary, I think the benefit of the doubt is required. After all, child protection was called on the parent; even having dealt professionally with child protection overreach myself, the straightforward way to interpret the situation is that there are other concerns with the home environment.