Parental Consent

Illustration by R. Daniel Proctor

Voices build momentum after Tennessee’s mature minor law gets a clarification from the governor

The extent of the state’s ability to decide that minors of a certain age can make their own medical decisions while keeping their parents in the dark—Tennessee’s “mature minor” law—is under renewed scrutiny.

Parents upset over Tennessee law allowing kids to get vaccinated without parental consent” is the headline of a WTNZ-TV, Nashville story from late June. “Mimi Pohlam says she and her husband make the decisions for their kids…She believes it’s their place to make decisions for their kids, not the government’s—especially when it comes to the Covid vaccine. ‘I don’t want the state or federal government to raise my children. I would like to make those decisions and I have the right,’ said Polham.”

Not necessarily, mom. Tennessee, like many states, is somewhat schizophrenic about parental authority over children. For example, there are laws that put parents squarely in the financial cross-hairs (figuratively speaking) if their children engage in behavior resulting in personal injury or property damage. At the same time, the “mature minor” law lets children act independently of their parents in decisions affecting their health.

“Tennessee children are legally allowed to make a variety of medical decisions for themselves,” said an article titled, “Is Your Tennessee Teen a Mature Minor?” in the February-March 2022 edition of the Nashville Bar Association Journal. “A teen has a right to be treated for a sexually transmitted disease without parental consent. A child may seek prenatal care without a parent’s knowledge or consent. A teen may also be able to make mental health care decisions, including taking medications, without his or her parent’s knowledge or consent. This specific decision-making authority is provided by statute…This doctrine creates a presumption that mature teenagers can make medical decisions, and consent to treatment, for themselves.”

Covid-19 and controversies surrounding vaccines and vaccinations were a continuing headache for health departments through the pandemic. Confusion was understandable. In spring of 2020, Americans were warned of the potential dangers of a “rushed” vaccine. However, by December 2020, many medical authorities declared the vaccines safe and effective. These were contradictory positions. Parental questions or hesitancy was justifiable.

In May 2021, the Tennessee Health Department sent a letter to its “Covid-19 Vaccinating Partners.” The letter explained that parents could be left out of the loop regarding child vaccinations and described the three stages of mature minor consideration:

• Under the age of 7 there is no capacity, and the physician must have parental consent to treat (unless a statutory exception applies)

• Between the ages of 7 and 14, there is a rebuttable presumption that there is no capacity, and a physician generally should get parental consent before treating (unless a statutory exception applies).

• Between the ages of 14 and 18, there is a rebuttable presumption of capacity, and the physician may treat without parental consent unless the physician believes that the minor is not sufficiently mature to make his or her own health care decisions.

“There is no federal, legal requirement for parent or caregiver consent for COVID-19, or any other, vaccine,” the letter said. Thus, under the law, responsibility for parental decisions is removed from the parent and turned over to a health care provider. 

The “Mature Minor Doctrine Clarification Act” was filed in the Tennessee legislature to deal with the mature minor law as it relates to vaccinations, Covid-19 and others—but not about STDs, pre-natal care, or mental health. The bill prohibits providers from “providing a vaccination to a minor unless the provider first receives written informed consent from a parent or legal guardian of the minor.”

Piecemealing a law isn’t something legislators typically like to do because it opens the door to pressure to amend other parts of the law; in this case, such as pre-natal care or taking other medications without a parent’s knowledge or consent. Nevertheless, the “Mature Minor Doctrine Clarification Act” passed, and Gov. Bill Lee signed it into law on May 17, 2023.

Arguments about vaccinations are part of a larger parental rights issue confronting the country. Provisions in law typically address irresponsible parents. The mature minor law, however, takes from all parents the ability to render judgement, or even know, if their child is making decisions that profoundly affect their health. The argument isn’t over, and is almost certain to become louder.  

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