Our AG wants every sexually active minor turned in to SRS/police - Page 2

[Jennifer Z]

KS resident here. I don't have a vested interest in this (yet), but am appalled that a teen would be justifiably afraid to seek medical care.

I don't have money or expertise to fight this, but I am willing to write a letter or something. I really feel like I need to clearly understand this before I do that so I don't look foolish.

Is this right: Not a new law, but a reinterpretation of an old law. Does that mean that nobody has actually been subjected to this law yet and we are talking about "if" a school nurse/clinic worker has a 14 year old seeking birth control options for whatever reasons, the nurse could be sued/lose liscence if they don't tell Cline's office that she was there? And, if Cline's office enforces the law the parents are reported to SRS and might lose custody of their kids?

If that is correct, that is astonishingly horrible.

Also wondering who I need to write a letter to.

[Delilah]

Absolute insanity

I'm so enraged I don't know what to say.

I think it is bad enough that the parents would have to be called over a young teen's sexual history, because they wouldn't want to seek medical care then, either, but calling social services? I wouldn't take my daughter in to the doctor either for fear that they'd come to my door to harass us. I'm also afraid that more women are going to cry rape when there was none, which makes it even harder for real rape victims to get the help and empathy they need.

Similar lines of thought: the business in Florida about girls having to provide a sexual history when placing a baby for adoption might end up causing more of them to abort, dumpster-dump, or leave their babies anonymously at hospitals. Their own rules create ironic situations.

I'm sick of "conservatives" wanting to micromanage our sexuality.

[Greaseball]

So if two 14-year-olds are having sex, they are each comitting a crime as well as being a victim of the other's crime? That makes no sense! How can one be a victim and a criminal at the same time?!

This reminds me of this girl I knew who got pregnant when she was 12 and the "father" was 25. She had the baby at 13. When her parents found out she was pregnant, they threw her out of the house. So she was homeless for her whole pregnancy and after the baby was born. It was the middle of winter and they both were living in a car.

This girl was not able to get any social service agency to help her and her baby because she did not provide the "father's" name so the agency could report him for child abuse. They called her "an accomplice to his crime" and because of this they decided to punish her baby by withholding services such as welfare, housing, food boxes and clothing donations.

I actually called the police because I feared for the baby; I said I thought it would be better in a foster home. I realize now this was none of my business and foster homes are not necessarily better than being homeless. This was several years ago and I don't know what happened to either of them. I never knew if this girl even wanted to be a mother or just could not afford an abortion. The baby, as far as I could tell, was not healthy. The police said they could not take the child without the consent of the "father."

Victims should not be treated like criminals, and babies should not be punished because of anything their parents do.

[miriam]

Sorry, but I agree with your AG. He should enforce the law - that is his sworn service to the public. Or get the law off the books.

I was an adolescent during the swinging 1960's and disco 1970's.
There were plenty of temptations, and few real consequences for young women who would have free sex and had an unplanned pregnancy or STD's. Abortion was legal in CA and there was plenty of penicillin to go around for whatever ailed you after a sexual trist.

I never had sex until I was married because I wanted to wait.

I got my education, married, and then had sex; children followed.

I had many problems with my teenage daughter tho...the police officers refused to enforce the laws that are on the books. The police officers get few "career points" for enforcing statutory rape laws. They would rather be doing something else to make the next grade.

So unless you are willing to enforce a law, get it off the books.

[Arduinna]

*

[SummerLover]

another similar line, in CA you also have to provide a sexual history (dates, times, places, witnesses to any sexual acts) if you are applying for Medi Cal for a child. It goes to the DA and if you refuse to fully answer the questions you can be prosecuted. This is even if the fathers name is on the birth certificate. Of course it's possible that things have changed as I learned of it about 7 or so years ago.

:

I don't think that health professionals can be compelled to give patient information under these circumstances, and Greaseball's story is probably a good example of what would happen if this AG's opinion were followed.

[lorijds]

Just an update, our governor is having a meeting today to discuss how this will affect health care providers.

She also stated that she felt this opinion could extend to those merely providing other services to teens who admit to being sexually active, and this meeting today is to discuss how it could affect teens and their health care providers, and whether she should issue a statement encouraging compliance with the AGs position, or take it to court, or encourage the legislature to basically create a new law that frees teens to seek medical care without fear of their families being turned into the police or SRS.

[Deirdre]

Please know that I say this 100% in jest....but what_is_up with the state of Kansas???

Are they trying to win the a prize for being the most sexually repressive state in the union?

:

[lorijds]

I don't know...maybe Kline and Wagle need to get to know each other in the biblical sense! They definately are both waaaaaaaay too tense!

[lorijds]

Miriam, you say there there are plenty of temptations and few consequences.....

Well, the consequence of seeking medical treatment shouldn't be a state investigation. The consequence of an STD can be pretty devastating.

Whether you agree with it or not...the result of the change in the interpretation of the law will be young women not receiving care for STDs, not receiving birth control, and not receiving annual paps. Who are most at risk for dying of cervical cancer? Women who haven't received a pap in 5 years or more. Your insurance premiums and taxes will be paying for expensive therapies that could have been prevented with routine health care. Paying for prenatal care, birth, and follow up for teen moms is a hell of alot more expensive than supplying them with information and birth control. The care for STDs that have gone untreated is awful.

I once cared for a man who had syphillis...for ten years. He had been infected, didn't seek treatment, later married, infected his wife (she didn't know until later). When I took care of him, he was in the hospital's medical floor, after being initially admited to the mental health unit....because untreated syphillis can make you go insane. He was there because, at the age of 25, he started having mental illness problems that didn't respond to treatment. His wife left him, he couldn't work, he had to move in with his parents. Then one day they came home from work to find him covered with blood, and all their pets decapitated...the voices in his head had told him that they wouldn't kill him if he would kill the cats and the dog. In the mental health unit he had a reaction to a drug that sent him to the ICU, where they did a bunch of blood tests and discovered the syphillis. A simple round of antibiotics shortly after infection would have saved so much pain and suffering. This man will live for quite some time, and never on his own--he will probably be institutionalized until he dies. What are the costs, not only to tax payers and society, but also in terms of this poor man's life?

Do you really want the rates of syphillis, chlamydia and the like to increase? What about teen pregnancy? It just breaks my heart to think of some girl in pain from a sexually transmitted disease who is also scared to seek treatment because she is scared SRS is going to show up at her door and get her parents and family in trouble.

And well woman exams, as well as those exams that involve treatment of STDs are GREAT opportunities to discuss the consequences of sexual activity, as well as educate the girl about safe sexual activities and behaviours. We will lose this opportunity to have this discussion if the girls aren't even coming in, or if, during an annual physical when I ask a girl if she is sexually active and she lies and says no.

I'm sorry about your experiences with your own daughter, Miriam, I don't wish unhealthy relationships upon anyone. But I do think that everyone deserves good health care without the fear of state involvement. I have worked with too many teens over the years (and was a rebellious one myself once upon a time), and I don't see how this interpretation of the law is designed to be helpful. I do vividly see how it will harm young women. But I am a bleeding heart liberal (I readily admit that!!) who believes that even young women who are making poor choices deserve respect and access to good health care. Sometimes I'm like that to a fault, I know. But I just feel really strongly about health care access.

[Marlena]

Woohoo!! You go, Lori!!!

[Greaseball]

Non one deserves to be punished for having consensual sex, becoming pregnant or getting an STD. They deserve confidential, respectful, affordable medical treatment and nonjudgmental support.

[miriam]

Everytime anyone goes to a health professional, their name, address, and social security number are collected.

Whatever and whenever anyone in this country goes into a health professional for, the ground work has already been laid for making an official report to the government.

Many memebers of my family are healthcare professionals and they use this for credit reporting and insurance information, but there is already the networking ready to report the health history of everybody who has ever been to a doctor, dentist, or other health care professional.

If you want the government out of your bedroom, you might want to start with keeping them out of your wallet.

[miriam]

When a woman goes to the hospital and has her baby, the birth certificate is filled out.

On the birth certificate in CA, in most other states and in the UK, there is a score given regarding information about the mother.

WHY?

Who cares?

I do not know who cares but it is there. The score is:
Total times pregnant/
Total miscarriages/
Total terminations/
Total live births to date to this woman. (variations on this theme exist from state to state)

In CA there is also ethnic/racial information taken, information taken regarding who paid for prenatal care, information taken as to when prenatal care began, and any STDs the mother is treated for or has had.

Post Script: When a doctor asks you if you have had the flu and you say,"NO", they write, "NO" on the information form.

When a doctor asks you if you have had STDs, and you say,"NO," the doctor writes, "Patient denies STDs."

Why is that standard operating procedure?

[barbara]

When a doctor asks you if you have had the flu and you say,"NO", they write, "NO" on the information form.

When a doctor asks you if you have had STDs, and you say,"NO," the doctor writes, "Patient denies STDs."

Why is that standard operating procedure?

Good question!!!

no one answered CerridwenLorelei's question.... what happens if the 16 year old is legally married because her parents signed the consent form to allow it?

In many cultures 16 is not considered a child. Regardless of if one agrees morally or not, in the 21st century American culture, it is not unusal for a 16 year old to be sexually active. So why is it the buisness of "health professionals" or "legal authorities?"

Our state does not have a SRS, and the name frightens me. Social Rehablitation Services!?! Sounds very Orwellian to me!

[lorijds]

16 isn't considered a minor....it is under 16. I don't know if a child under the age of 16 can marry in this state, so I can't answer that question.

As to the question "When a doc asks you if you have the flu and you say no they write no, but if a doc asks you if you have an STD and you say no, they say denies STD. Why is that standard operating procedure?"

This is not standard operating procedure. I would *never* ask anyone if they have the flu, in part because most people don't even know what the flu is. *Symptoms* are what one asks for. In the case of the flu, I would write "Pt reports cough productive of yellow sputum x 3 days. Pt reports muscle aches, pt attributes these to coughing fits. Pt reports inability to sleep "because I am coughing so much at night." Pt denies fever, head congestion. Pt reports history of frequent upper respiratory infections.

With an STD, it is the same. I would *never* ask "Do you have an STD?" That is a silly question, I have never heard anyone ask that. I would write something like "Pt reports vaginal dc et itching x 5 days. Pt reports dc is yellowish et odorous. Pt denies change in sexual partners."

It is the standard when documenting that if the patient says something, you write "pt reports" because if you just write "Pt has dc x 5 days." Well, you don't really know if the pt has had dc x 5 days. Maybe it was four, maybe 6. If you write, "Pt has no fever" you are stating that the patient has no fever. If you ask the pt if they have a fever and they say no, you document "Pt denies fever." Because all the data that you are collecting right now is *subjective*, and you must indicate it as such. Even if I took someone's temperature, I wouldn't necessarily write, "Pt has no fever." I would write the exact temperature on the progress notes.

Whether you think this is how documentation should be or not (most people seem to raise their hackles at the use of the words "denies" or "reports"), everyone has to document like this. It is the standard that *everyone* is taught in every medical and nursing school. When your agency is audited for whatever reason, if you do not document like this, you will be fined/marked down/whatever for improper documentation. *ALL* documentation must be like this, whether in a doctor's office, hospital, or visiting nurses. I don't believe that doctors or nurses are asking people "Do you have the flu?" or "Do you have an STD?" That is just not how it is done, and it wouldn't be very productive.

The use of "reports" and "denies" isn't because we dont' believe you...it is because we are collecting subjective data and need to indicate it as such. Documentation is a legal event, and it *must* (by law and by the standards set by accrediting agencies and by the nursing and medical boards) follow certain standards. Doctors and nurses who do not follow this method of documentation are not following the standard of care, and will probably be nailed at some point or other.

Hope this helps explain the terminology and the purpose of our methods of documentation.

[Greaseball]

I have read that is the standard procedure in many areas. The health professional will ask "Have you ever had any STDs?" and then will write "Pt denies STDs."

This may sound overly simplistic, but here's my theory on that - many doctors hate women! If I hated women and wanted a job where I could act out my hatred in a socially acceptable way, I would become an OBGYN. Or maybe a psychiatrist.

Of course, many doctors - including male ones - do respect women.

[lorijds]

If you have a history of having an STD, you are statistically more at risk for cervical cancer than someone who has not ever had an STD. There are two different types of paps currently done. At our office, we do the slide style pap for those who are not at risk for cervical cancer. The "thin prep" style pap we use for those who have previously had an abnormal pap or who are at risk for cervical cancer. It could simply be that the doc is trying to ascertain the patient's risk status for cervical cancer. There is also a place on the requisition form for many labs to mark whether the pt is at risk for cervical cancer.

I mark yes if a patient has a history of STDs, has had certain abnormal pap results in the past, if the patient doesn't seek regular health care and paps, if the patient is a moderate to heavy smoker, if the patient has multiple sexual partners, if the patient was sexually active at a young age, or if the patient uses oral contraceptives. Currently, all of these factors are considered risk factors for cervical cancer. Many labs have the paps of those at risk for cervical cancer screened at a higher level (like, by two different cytologists), or reviewed more carefully in some other manner, so I want to make sure that nothing gets missed.

I'll bet that he doesn't write "Pt denies STD." He will probably write "Pt denies hx of STDs." That is simply good history collection. You are statistically at greater risk for several health problems, including cervical cancer, if you have a history of STDs. Also, if you are having some sort of vaginal or reproductive "issue" (vaginal discharge, pelvic pain, mentrual irregularities, urinary tract issues, abdominal pain, etc) that is one of the first questions to ask. It is always possible you have been reinfected (like, your partner has not been properly treated, or you are still engaging in behaviours that put you more at risk, like not using condoms), or that your initial treatment was not successful -- several "bugs" are now showing resistance to certain initial therapies, and must be dealt with more aggressively. There is nothing wrong with gathering that sort of data when one is treating your health!

[Jennifer Z]

Thanks for the explanation of the termonology. It does sound rather harsh if you don't understand why it is written that way, but makes complete sense when you explained it.

[Greaseball]

That still doesn't explain why they will write "No" when a patient denies high blood pressure but "Denies STD" when the patient says "No" to the hx of STDs question.

Mendelsohn talks of this in his "How Doctors Manipulate Women" book - that as a doctor, he was trained to see females as lying buckets of STDs and other germs. A doctor in his med school covered himself with slime for Halloween and said he was "going as a woman."