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In an age where a parent’s right to direct their children’s healthcare is being eroded, we need a true collaborative model of healthcare especially for adolescents. In the past we challenged the healthcare system when our legislators gave doctors permission to treat our children’s sexually transmitted diseases without our knowledge or consent. We lost.

Now we face another equally challenging situation. Our leaders and medical experts believe that they have a right to vaccinate our children with or without our consent thanks to the Mature Minor Doctrine. As the paper below explains, Tennessee law gives healthcare providers permission to treat children under 18 without parental consent or even knowledge.

When will this erosion of parental rights come to an end? To understand how the healthcare system should interact with parents and children read my paper. After reading, stand with others to say no and offer a real solution.

Thank you for taking the time to read, reflect, and stand for reason.

Dr. Eric Potter


 

NOTE: My original paper was written in 2010 when the state was pressing the mature minor consent policies in regards to treating adolescents for sexually transmitted diseases without parental consent or awareness by the parent.  I testified before a state legislative committee against the Health Department. Our side lost attempt to protect parental involvement and notification.  The same issue is now focused on COVID 19 vaccines.  This paper provides the summary of my “public” opinion with my medical and legal references at the end. It is written with an assumption that we want what is best for children and therefore medical providers should fully involve parents with medical decisions.  I have edited the paper to address the current vaccine related application of the mature minor doctrine.

 

Collaborative Care of Adolescents by Parents and Medical Professionals

 

In 2021, we now face the application of a legal concept called the mature minor doctrine to the administration of experimental medical therapies intended to lower a person’s risk of contracting COVID 19.  The mature minor doctrine is a state law in Tennessee which defines the ages during which an individual below the age of 18 years can consent to their own medical therapy.  Children aged 14-17 may receive medical therapy after they consent without parental consent or notification.  Under the discretion of the health care provider, children from aged 7 to 14 years may also consent if urgency and risk are high enough according to the treating physician.  While you obviously do not want an emergency medical provider to delay care of a child in a car wreck until parental consent is obtained, there are many less urgent decisions for which you do want them to wait.

With this Tennessee law in mind, the Tennessee Department of Health has advised the Department of Education that the mature minor doctrine allows leeway in the administration of experimental COVID vaccines to children under age 18 years even in the absence of parental consent.  If they follow the logical conclusion, schools with health staff like nurses can consent your child for the vaccine and administer it without your consent or knowledge.  Children will be asked if they want the vaccine and it could be administered with or without parental consent or knowledge.  The dangers of this approach are numerous.

Many of today’s medical professionals devote their careers to caring for children from all walks of life. Caring for their patients along with the parents, they seek to contribute to the health and well-being of a huge and vulnerable segment of our society. Legally, issues of privacy, medical liability, child abuse, and insurance coverage are creating many challenges for medical professionals in their daily management of adolescents.  Societally, the concept of the child, a changing timeline of childhood, sexual norms, drug use, and child abuse are also daily increasing the demands on these same professionals across all demographics.  Change seems inevitable but there are some general principles which are enduring that can guide caregivers through the turbulence including the turbulence of experimental therapies for COVID 19.

The purpose of this position paper is to take an important first step in answering these challenges by showing that medical professionals should approach their adolescent patients through collaborative decision making that prioritizes parental stewardship.  While not the only goal for these professionals, the protection and development of parental stewardship is necessary for a number of reasons. Parental stewardship in the medical decision-making process is the best for children and their families who love them, because the practice of such stewardship fosters optimal long-term benefits to the child and the family.  While not directly addressed here, one could extrapolate this benefit to society as a whole as well.  This paper will work through the practical aspects of this approach, aiming to persuade others of this thesis while recognizing further study and policy work are still needed beyond this position paper.

Various additions to the original paper will address specific risks associated with the administration of experimental therapies in the attempt to prevent COVID-19.

In order to lay out a defense of this position a number of points will need to be combined in a logical manner.  Some sections and points need no reference as common experience confirms their validity.  In other words, studies do not add to common sense and shared experiences in those instances.  In other areas, references will be summarized and/or listed for further investigation as the readers’ desires dictate.  Both sets are listed below.

Whereas:

  • Medical professionals caring for adolescents cannot ignore the issue of who determines adolescent’s health care.
  • A methodical and thorough process is required for achieving optimal decisions in the care of adolescents in these challenging situations.
  • One must presuppose that parents act in the best interest of child until proven otherwise.
  • Science has found that the maturation of adolescents’ brains, in areas critical for decision making ability, is not complete until they reach their twenties.
  • Social science research correlates parental involvement with positive outcomes in teenager’s risk-taking behaviors and outcomes.
  • Parental rights are a fundamental legal right protected repeatedly by United States Supreme Court cases since 1925.
  • The administration of an experimental medical therapy without parent consent or awareness provides an opportunity for several adverse events to occur without equal opportunity for proper medical responses.

Therefore:

  • Medical professionals and school officials must approach parents with a primary goal of encouraging parental stewardship of the adolescent’s health. The non-parents should interact with the adolescent through parents rather than usurping the parent’s authority.
  • As a corollary, they must take great caution in interjecting between parent and adolescent as perceived short-term benefits may be lost as a result of longer-term interference in the parent-adolescent relationship.
  • In the end, non-parents should encourage parents to lead the adolescent, and should encourage the adolescent to follow parents’ decisions.
  • In regards to the 2021 attempt by public health authorities to promote the administration of experimental medical therapies known as vaccines, school and medical professionals should NOT bypass parental informed consent for medical decisions that involve life or death outcomes.

Throughout the remainder of this paper, each point above will be discussed at least briefly (for those depending on commonly held beliefs) or at greater length for those which may be new data for the reader or more controversial to the reader.

Whereas medical professionals caring for adolescents cannot ignore the issue:

The first point is extremely simple and surely no one will argue with its validity.  The issue of medical decision making for adolescents is unavoidable and undeniable.  Any medical provider caring medically for any number of adolescents is reminded in their daily practice that such care is fraught with opportunity for ethical dilemmas.  On a less frequent basis, anyone reading journals or attending related conferences is aware of the number of opinions attempting to influence pediatric practice through various means.  Other unavoidable issues are the destructive societal trends facing adolescents in the areas of sexuality, drugs, and alcohol, not to forget parental divorce and school violence.  There are a multitude of long-term effects on children and families that cannot be ignored by anyone medically caring for this population.

Now, 2020 has added the question of COVID 19 experimental therapies known as vaccines to the ethical debate. Medical professionals must take a stand to protect the parent-child relationship or else become another arm of governmental public health experts imposing the collective will upon our children.

Whereas a non-reflexive, thorough process is required for achieving optimal decisions in the care of adolescents in these challenging situations:

Another simple reminder is inserted at this point that could almost go unsaid for these medical professionals.   The issues facing adolescents and their parents are very complex, involving spiritual, emotional, and physical consequences that could last a lifetime.  Furthermore, any damage to the adolescent’s relationship with his or her parents could have severe long-term consequences. Were that not enough, each adolescent’s situation is different although common themes repeat themselves.  No more should need to be said as probably all are nodding in agreement that these issues can rarely if ever be answered reflexively.  Medical decisions of this magnitude demand a measured degree of deliberation and careful application of wisdom.  Whether in the clinical setting or in public policy discussions, a thorough consideration of multiple factors is needed to achieve desired outcomes for these adolescents.

As for any age group, the risks and benefits of administering an experimental therapy to children must be weighed in each unique situation.  Given the very low risk of adolescents contracting a severe COVID 19 infection, the risks of side effects short term and long term must be considered.  There may be situations where adolescent’s health history suggests benefits greater than the risks. On the other hand, if the adolescent is not expected to benefit and the therapy is given solely to protect others, we must pause and be sure the risk does not outweigh the benefits.  Vaccinating children and putting them at risk in order to protect adults has never been done before.  The ethics are dubious at best.  The guilting of parents and their teens into taking the vaccine is detestable.

Whereas one must presuppose that parents act in best interest of child until proven otherwise:

The next point in this progression may not be as commonly accepted as the previous two points, but is important for the conclusion of this paper’s stand.  Medical professionals must presuppose that parents are acting in the best interest of the child as mediated by the interests of the family and society.  Stated another way, caregivers must not assume that parents are seeking harm for their children unless clear evidence and due process indicate that they are doing so.  This takes into consideration that no parents are perfect.  However, given the sacrifice of parents over years of parenting, caregivers should assume that most are “doing their best”.  Furthermore, given the parent’s long term familial intimacy with the adolescent, they are most likely the ones who know their needs, personality, and desires better than any other.  There will always be a small number of exceptions to this generalization, but the approach that parents are doing what is best for the adolescent should be the consistent presupposition until proven otherwise.  A later section will address how our legal system has upheld this presupposition in the courts.

In regards to COVID 19 experimental prevention therapies known as vaccines, removing parents from the informed consent process without due process of legal proceedings amounts to subversion of the parent-child relationship.  It flaunts an attitude that the parent does not want the child’s best and the medical provider has the power to usurp parental authority.  This is a prideful and dangerous stance to take.

Whereas science has found that the maturation of adolescents’ brains, in areas critical for decision making ability, is not complete until in their twenties.

A growing understanding of how the brain matures through childhood into adulthood will serve two purposes.  First, it will begin to answer the objection to the last point which states that an adolescent knows what is best for them.  The maturation process of the brain does not physically come to completion, especially the executive decision-making area of the frontal cortex until sometime in the early twenties.  This significantly undermines such an objection.  Ultimately, adolescents are not physically equipped to make the best decisions for themselves.  Second, it explains with research and medical proof what most have known for centuries:  adolescents engage in risky behavior and make decisions considered less than optimal by more experienced observers.  These decisions involve health consequences that may be life-long when they involve risky behaviors.

A number of areas of research are improving our understanding of brain development.  One such area is the use of functional MRI studies (3,4).  Studies have looked at how different age children process emotional responses to stimuli through the use of functional MRI’s which measure activity level in specific brain structures.  Before maturation of the frontal cortex, Baird et al showed that children depend on their amygdala for such responses.  This area is where “gut” feelings and fear are processed.  After maturation of the frontal cortex in their mid 20’s young adults have more reasoned perceptions and improved performance on the same tests (4).  Another use of MRI technology is to follow the maturation of neurons, their axons, and their synapses throughout the teenage years into adulthood.  Such studies performed by Johnson et al and Sowell et al, showed that the frontal lobe, the area of the brain responsible for decision making remains underdeveloped until the early 20’s.  It serves as the “inhibition center” of the brain allowing the individual to limit acting on their initials impulse. Thus, adolescents do not have the neuronal capacity to make decisions involving impulse or risk with the same level of maturity as adults (1,2).  Therefore, they have neither experience as a guide nor strong mental capacity for addressing high risk behaviors.  Again, this confirms what nearly anyone who knows a teenager has known for centuries.

Another area of research concerns the effects of hormones on the developing brain.  Not only have we discovered that the sex hormones estrogen and testosterone have receptors in the brain, but also that well known neuro-transmitters such as dopamine, serotonin, oxytocin, and vasopressin also affect brain maturation.  For example, dopamine is one of the main hormones related to addictive behavior (5).  Adolescents are at increased risk for such behaviors possibly due to the effects of changing dopamine levels during risk taking behaviors.  Beyond these hormones, oxytocin and vasopressin are hormones which play a role in the bonding behaviors of women and men, respectively, during sexual interactions (6).  Some studies are showing that early sexual behavior is detrimental to the growth of various areas of the brain (6).

Taken together as a longer section with the references in the bibliography, it is clear that functionally and anatomically the adolescent’s brain is not capable of the type of medical decision making facing them today in regards to experimental so called vaccines.  They cannot process appropriately the risk – benefit balance necessary for wise decisions that may affect their future.  While not directly addressed by the cited studies, it is not an unreasonable extrapolation to say that they are unprepared for such medical decisions.  For once, it is not their fault.  Their brains need more time for maturation and they will benefit from the careful guidance of those closest to them, their parents.

In regards to COVID 19 experimental therapies, can we expect an adolescent with an underdeveloped brain swimming in hormones to fully understand a life and death decision regarding a vaccine?  There is no urgency to indicate a need for bypassing parental involvement.  This is especially true in situations where school officials use peer pressure and segregate out students who don’t wear masks or don’t receive the so-called vaccines.  When medical professionals or school officials say they are advocating for children’s rights to a vaccine, they are actually placing themselves in the authority role usurping the parent.

Whereas social science research correlates parental involvement with positive outcomes in adolescent’s risk taking behaviors and outcomes:

Having addressed some basic biological impediments to adolescent’s capacity for autonomy in medical decision-making, the next point addresses the primary theme more from the viewpoint of sociological research.  A large number of studies have proven something that should not surprise caregivers of adolescents.  Parental involvement in their lives greatly increases the chances of achieving the best outcomes in terms of sexuality and its potential consequences, in terms of adolescent’s mental health, and in terms of drug related behavior.  A number of studies which are provided in Appendix A show that greater parental involvement, greater parental oversight, greater amounts of parent-teen communication, and other such practices lead to less sexual activity, less drug use, greater life satisfaction of adolescents, and other desired benefits.  With such an impressive list of studies showing the benefit of parental involvement in adolescents’ life decisions, should medical professionals think that adolescents should be separated from their parents when making potentially life altering medical decisions in areas of life altering medical decisions?  These studies have their limits as does any sociological study, but they are rather convincing especially when read in context of the remainder of this paper.

Whereas parental rights are a fundamental legal right protected repeatedly by Supreme Court cases since 1925:

Pragmatically and ethically speaking, medical professionals should strive to obey the spirit and letter of the law.  There are two sides to this area of debate.  First, in general the law regarding parental rights to direct the care and upbringing of their children is clear (emphasis mine).  Several Supreme Court Cases in our nation have upheld this parental right as a fundamental right, one which requires a high burden of proof to overrule.  One case, Santosky v. Kramer from 1982 is quoted below and speaks for itself.

The fundamental liberty interest of natural parents in the care, custody, and management of their child does not evaporate simply because they have not been model parents or have lost temporary custody of their child to the State. Even when blood relationships are strained, parents retain a vital interest in preventing the irretrievable destruction of their family life.

Until the State proves parental unfitness, the child and his parents share a vital interest in preventing erroneous termination of their natural relationship.

– Santosky v. Kramer, 455 U.S. 745 (1982)

Several other similar cases from the US Supreme Court and other courts are listed in Appendix B.  They all uphold the right of parents to direct the care of their children, but due process (a necessary part of a fundamental right) may limit or remove that parental right if clear danger may come to the adolescent without doing so.  Short of this, according to our nation’s laws, parents should be viewed as the primary decision maker when caring for adolescents.

The other side of this debate serves to mitigate the impact of this higher-level legal understanding.  The readers of this paper should be aware of their particular state laws regarding care of adolescents especially ones that address confidentiality and parental notification/consent for treatment.  Different states have set differently nuanced regulations for the care of adolescents.  These regulations should guide medical professionals, but are not the ultimate goal in the care of adolescents.  They are rather a means to the best care of adolescents.  In summary, medical care is a somewhat special case in the overarching balance between parental rights and adolescent autonomy.  However, professionals can easily apply the conclusions of this paper within those state mandates, both respecting parental authority and seeking the adolescent’s best interests.  These two goals are not mutually exclusive.

Whereas, the administration of an experimental medical therapy without parent consent or awareness provides an opportunity for several adverse events to occur without equal opportunity for proper medical responses.

Simple common sense and a few minutes of time uncover a number of pragmatic risks of a school policy in which adolescents are allowed to consent to an experimental therapy without parental awareness.  The most significant are listed below, but others may be extrapolated from them.

  1. The adolescent may not be aware of a medical condition which places them at higher risk for adverse effects of the experimental therapy.
  2. If the adolescent has delayed side effects until returning home, the parent will not be aware of the potential for side effects. This will prevent the parent’s proper response to those symptoms.
  3. Should an adolescent have side effects that require medical attention, the treating physician may not have this knowledge of the therapy and thus not be able to respond appropriately, risking a poor outcome for the adolescent.
  4. Should the child have side effects delayed by years, they may not connect the experimental therapy to their present symptoms nor convey the information to treating providers.
  5. Adverse events, immediate or delayed will be less likely to be reported to the national adverse event reporting system known as VAERS.

Given these risks, any school official promoting or providing vaccines without parental consent or awareness is violating basic principles of ethics.

THEREFORE:

  • Medical professionals must approach parents with a major goal of encouraging parental stewardship of the adolescent. The professional should interact with the adolescent through parents rather than usurping the parent’s authority.
  • As a corollary, they must take great caution in interjecting between parent and adolescent as perceived short-term benefits may be lost as a result of longer-term interference in the parent-adolescent relationship.
  • In the end, professionals should encourage parent to lead the adolescent as a steward, and should engage the adolescent to follow parents’ decisions.
  • In regards to the 2021 attempt by public health authorities to promote the administration of experimental medical therapies known as vaccines, school and medical professionals should NOT bypass parental informed consent for medical decisions that involve life or death outcomes.

While much work and investigation needs to be carried out in this area, the preceding statements lead to the following working conclusions, at least until further refinements can be determined.  Foremost, caregivers should coach parents to be stewards of their adolescents through the medical decision-making process rather than usurping the parental role.  Upholding the parent-adolescent relationship with the parent as the authority provides the best long-term benefit to the adolescent and the family.  The medical professional should not take authority into their own hands unless they are willing to assume the responsibility for that teen which the authority entails.  Coaching parents through the process equips them to act as stewards of the adolescent by seeking what is best for the adolescent in the context of a respect for parental authority.  Stepping in between the adolescent and their parents weakens and may even undermine the parent-adolescent relationship.  Adolescents may then be inadvertently encouraged to deceive parents in order to receive medical care in privacy as an autonomous individual rather than as a member of a family structure.  Such intervention denies parental authority and diminishes parental responsibility.  Both prevent proper stewardship and unnecessarily interfere with the family’s sphere of authority.

Given the general opinion above that medical professionals should address the parents as stewards and address the adolescent through this framework, the reality of exceptions to the rule must be thoughtfully considered.  In instances where clear evidence and due process (degree of which will depend on urgency of situation encountered) indicate that a parent is not able or desiring to make the best decision for the child or is derelict in that duty, the caregiver should cautiously intervene between parent and adolescent.  At the very least, abuse, neglect, obvious conflicts of interest, and emergency situations demand an exception to the primacy of parental stewardship.  This should be minimized in frequency, extent, and length of time.  A reminder to recall the earlier section on wisdom and time is necessary here.  Long term and short-term benefits versus risks must be carefully weighed.  With all this in mind, it is sometimes necessary to intervene rather than coach towards stewardship.

In the end, parents must be encouraged and equipped in their authority as caregivers, and simultaneously medical professionals must vocalize expectations of stewardship responsibility to the parents.  Caregivers should state such expectations clearly in front of the adolescent and the parent.  Then the parent, while involving the adolescent, should be expected to make the decision.  To be clear, based on the adolescent’s maturity level, the parent should undoubtedly listen to and consider the adolescent’s input on the decision to be made.  However, ultimately, the decision belongs to the parent.  If the adolescent disagrees with the parent’s decision, further work is necessary along the lines above.  Parental involvement is necessary even if eventually the adolescent continues to choose against the parent’s wishes.  This paper will not address that quandary as it would require greater depth than permitted here given time and space.  Further work by the parties involved needs to occur in order to properly guide the practicalities of such situations.

In closing, parental stewardship in the arena of adolescent medical decision making is one of the primary considerations that must be recognized by all parties involved.  Anything less places the adolescent in a situation they are not capable of handling and goes against research indicating the long-term benefits of parental involvement in adolescent’s life.  Pragmatically it is more beneficial to not arbitrarily intervene in the parent-adolescent relationship unless clear evidence combined with due process or an emergency necessitates.  The medical professional should aim for coaching parents towards stewardship of their adolescents when making medical decisions.  Practice guidelines, legal policies, and parents should embrace these principles of parental stewardship alongside medical professionals as we move forward together in this area of caring for adolescents.

Bypassing the parent’s role by administering an experimental therapy which offers minimal benefits to the receiving adolescent strikes us as unethical and unAmerican.  Parents must not allow medical providers to take over the lead role in our children’s health care.

 

 

Directly Cited Bibliography

 

  1.  J Adolesc Health. Author manuscript; available in PMC 2010 June 27.

Published in final edited form as:

J Adolesc Health. 2009 September; 45(3): 216–221.

 

Adolescent Maturity and the Brain: The Promise and Pitfalls of Neuroscience Research in Adolescent Health Policy

Sara B. Johnson, Ph.D., M.P.H,a* Robert W. Blum, M.D., Ph.D,b and Jay N. Giedd, M.Dc

 

  1. Nat Neurosci. 1999 Oct;2(10):859-61.

In vivo evidence for post-adolescent brain maturation in frontal and striatal regions.

Sowell ER, Thompson PM, Holmes CJ, Jernigan TL, Toga AW.

 

  1. Strauch, Barbara  The Primal Teen – What the New Discoveries About the Teenage Brain Tell Us About Our Kids.   Doubleday, 2003.    Page 33.

 

  1. Baird AA, Gruber SA, Fein DA, et al. Functional magnetic resonance imaging of facial affect recognition in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 1999; 38(2): 195-9.

 

 

APPENDIX A

 

Social Sciences studies which support parental involvement in adolescent decision making:

 

FAMILY FACTS LIST

  1. Vincent Guilamo-Ramos et al., “Parental Expertise, Trustworthiness, and Accessibility: Parent-Adolescent Communication and Adolescent Risk Behavior,” Journal of Marriage and Family 68, No. 5 (December 2006): 1229-1246.
  2. M. A. Longmore, W. D. Manning and P. C. Giordano, “Preadolescent Parenting Strategies and Teens’ Dating and Sexual Initiation: A Longitudinal Analysis,” Journal of Marriage and Family 63, No. 2 (2001): 322-335.
  3. D. P. Hogan, R. Sun and G. T. Cornwell, “Sexual and Fertility Behaviors of American Females Aged 15-19 Years: 1985, 1990, and 1995,” American Journal of Public Health 90, No. 9 (2000): 1421-1425.
  4. L. B. Witbeck, R. L. Simons, and M. Y. Kao, “The Effects of Divorced Mother’s Dating Behaviors and Sexual Attitudes on the Sexual Attitudes and Behaviors of Their Adolescent Children,” Journal of Marriage and Family 56, No. 3 (1994): 615-621.
  5. Carol A. Ford et al. “Predicting Adolescents’ Longitudinal Risk for Sexually Transmitted Infection,” Archives of Pediatric Adolescent Medicine 159 (July 2005): 657-664.
  6. Hogan, “Sexual and Fertility Behaviors of American Females,” 1421- 1425.
  7. E. W. Young et al., “The Effects of Family Structure on the Sexual Behavior of Adolescents,” Adolescence 26, No. 104 (1991): 977-986.
  8. A. Thorton and D. Camburn, “The Influence of the Family on Premarital Sexual Attitudes and Behavior,” Demography 24, No. 3 (1987): 323-240.
  9. Melina Bersamin et al., “Parenting Practices and Adolescent Sexual Behavior: A Longitudinal Study,” Journal of Marring and Family 70 (February 2008): 97-112.
  10. Cheryl B. Aspy et al., “Parental Communication and Youth Sexual Behavior,” Journal of Adolescence 30 (2007): 449-466.

Abstracts of particularly revealing studies:

Grace M. Barnes et al., “The Effects of Parenting on the Development of Adolescent Alcohol Misuse: A Six-Wave Latent Growth Model,” Journal of Marriage and the Family. 62, No. 1(February 2000): 175-186.

    • Parental support and monitoring appears to influence the likelihood of alcohol use by adolescents. Parental support was indirectly related to a decreased likelihood of adolescent alcohol use through parental monitoring. Parental support, which included praise, encouragement, and physical affection, was associated with an increase in parental monitoring. In turn, higher levels of parental monitoring were associated with a decreased likelihood of adolescent alcohol use.7

Maria Ketsetzis, Bruce A. Ryan and Gerald R. Adams, “Family Process, Parent-Child Interactions, and Child Characteristics Influencing School-Based Social Adjustment,” Journal of Marriage and the Family 60 (May 1998): 374-387.

    • Parental support can influence children’s ability to cope with failure and pressure, which affects their classroom behavior. There was a positive association between seventh graders’ frustration tolerance scores (“ability to cope with failure and other social pressures”) and the levels of support from their mothers and fathers, and a negative association between fourth graders’ frustration tolerance scores and the levels of support from their fathers. No significant association was found between fourth graders’ frustration tolerance scores and the levels of support from their mothers. Fourth and seventh graders, both boys and girls, described by their teachers as having higher levels of frustration tolerance were less likely to show internalized classroom problems (“withdrawn, somatic complaints, and anxious depressed behaviors”) and externalized classroom problems (“delinquent and aggressive classroom behavior”).2

 

Anne C. Fletcher, Laurence Steinberg, and Elizabeth B. Sellers, “Adolescents’ Well-Being as a Function of Perceived Interparental Consistency,” Journal of Marriage and the Family 61 (August 1999): 599-610.

    • Children of responsive and involved parents are more likely to perform better in school. Youth who described their parents as being highly responsive (e.g., were willing to help with their problems) were more likely to have higher levels of academic achievement and psychosocial development and lower levels of deviant behavior and psychological problems than peers who did not rate their parents as being highly responsive.4

 

Studies from Child Trends Data Bank Article Titled:  Sexually Experienced Teens

 

Child Trends (2010).  Sexually Experienced Teens. Retrieved from www.childtrendsdatabank.org/?q=node/121

Last update: July, 2010

 

“Teens who have good relationships with their parents—e g., are close to their parents, communicate about sex, and whose parents set rules and monitor their child’s whereabouts—are less likely to have sex at an early age.11,12”

 

11Commendator, K. (2010).  Parental influences on adolescent decision making and contraceptive use. Pediatric Nursing, 36:3.
12Longmore, M. A., Eng, A. L., Giordano, P. C., and Manning, W. D.  (2009).  Parenting and adolescents’ sexual initiation.  Journal of Marriage and Family, 71 (4), 969-982.

 

 

Two Other Peer Reviewed Resources

 

Journal of Behavioral Medicine

Peer and parental influences on adolescent tobacco use

Anthony Biglan, Terry E. Duncan, Dennis V. Ary and Keith Smolokowski

V 18, n 4, 315-330,

 

 

PEDIATRICS Vol. 93 No. 6 June 1994, pp. 1060-1064

Parental Monitoring and Peer Influences on Adolescent Substance Use

Laurence Steinberg PhD1, Anne Fletcher PhD1 , Nancy Darling PhD2

Appendix B

 

Parental Rights Case Law  From Parental Rights.Org Website (www.parentalrights.org)

 

Case index:

  • Meyer v. State of Nebraska, 262 U.S. 390 (1923)
  • Pierce v. Society of Sisters, 268 U.S. 510 (1925)
  • Prince v. Commonwealth of Massachusetts, 321 U.S. 158 (1944)
  • Ginsberg v. New York, 390 U.S. 629 (1968)
  • Wisconsin v. Yoder, 406 U.S. 205 (1972)
  • Cleveland Board of Education v. LaFleur, 414 U.S. 632 (1974)
  • Moore v. East Cleveland, 431 U.S. 494 (1977)
  • Smith v. Organization of Foster Families, 431 U.S. 816 (1977)
  • Quilloin v. Walcott, 434 U.S. 246 (1978)
  • Parham v. J. R., 442 U.S. 584 (1979)
  • Santosky v. Kramer, 455 U.S. 745 (1982)
  • Reno v. Flores, 507 U.S. 292 (1993)
  • Washington v. Glucksburg, 521 U.S. 702 (1997)
  • Troxel v. Granville, 530 U.S. 57 (2000)

It is the natural duty of the parent to give his children education suitable to their station in life.

– Meyer v. State of Nebraska, 262 U.S. 390 (1923)

The fundamental theory of liberty upon which all governments in this Union repose excludes any general power of the State to standardize its children by forcing them to accept instruction from public teachers only. The child is not the mere creature of the State; those who nurture him and direct his destiny have the right, coupled with the high duty, to recognize and prepare him for additional obligations.

– Pierce v. Society of Sisters, 268 U.S. 510 (1925)

It is cardinal with us that the custody, care and nurture of the child reside first in the parents, whose primary function and freedom include preparation for obligations the state can neither supply nor hinder. . . . It is in recognition of this that these decisions have respected the private realm of family life which the state cannot enter.

– Prince v. Commonwealth of Massachusetts, 321 U.S. 158 (1944)

The values of parental direction of the religious upbringing and education of their children in their early and formative years have a high place in our society.

Even more markedly than in Prince, therefore, this case involves the fundamental interest of parents, as contrasted with that of the State, to guide the religious future and education of their children.

The history and culture of Western civilization reflect a strong tradition of parental concern for the nurture and upbringing of their children. This primary role of the parents in the upbringing of their children is now established beyond debate as an enduring American tradition.

Wisconsin v. Yoder, 406 U.S. 205 (1972)

This Court has long recognized that freedom of personal choice in matters of marriage and family life is one of the liberties protected by the Due Process Clause of the Fourteenth Amendment.

– Cleveland Board of Education v. LaFleur, 414 U.S. 632 (1974)

Our decisions establish that the Constitution protects the sanctity of the family precisely because the institution of the family is deeply rooted in this Nation’s history and tradition. It is through the family that we inculcate and pass down many of our most cherished values, moral and cultural.

– Moore v. East Cleveland, 431 U.S. 494 (1977)

The liberty interest in family privacy has its source, and its contours are ordinarily to be sought, not in state law, but in intrinsic human rights, as they have been understood in “this Nation’s history and tradition.”

– Smith v. Organization of Foster Families, 431 U.S. 816 (1977)

We have recognized on numerous occasions that the relationship between parent and child is constitutionally protected.

We have little doubt that the Due Process Clause would be offended “if a State were to attempt to force the breakup of a natural family, over the objections of the parents and their children, without some showing of unfitness and for the sole reason that to do so was thought to be in the children’s best interest.”

– Quilloin v. Walcott, 434 U.S. 246 (1978)

The law’s concept of the family rests on a presumption that parents possess what a child lacks in maturity, experience, and capacity for judgment required for making life’s difficult decisions. More important, historically it has recognized that natural bonds of affection lead parents to act in the best interests of their children.

The statist notion that governmental power should supersede parental authority in all cases because some parents abuse and neglect children is repugnant to American tradition.

Simply because the decision of a parent is not agreeable to a child or because it involves risks does not automatically transfer the power to make that decision from the parents to some agency or officer of the state.

– Parham v. J. R., 442 U.S. 584 (1979)

The fundamental liberty interest of natural parents in the care, custody, and management of their child does not evaporate simply because they have not been model parents or have lost temporary custody of their child to the State. Even when blood relationships are strained, parents retain a vital interest in preventing the irretrievable destruction of their family life.

Until the State proves parental unfitness, the child and his parents share a vital interest in preventing erroneous termination of their natural relationship.

– Santosky v. Kramer, 455 U.S. 745 (1982)

“The best interests of the child,” a venerable phrase familiar from divorce proceedings, is a proper and feasible criterion for making the decision as to which of two parents will be accorded custody. But it is not traditionally the sole criterion-much less the sole constitutional criterion-for other, less narrowly channeled judgments involving children, where their interests conflict in varying degrees with the interests of others.

“The best interests of the child” is not the legal standard that governs parents’ or guardians’ exercise of their custody: So long as certain minimum requirements of child care are met, the interests of the child may be subordinated to the interests of other children, or indeed even to the interests of the parents or guardians themselves.

– Reno v. Flores, 507 U.S. 292 (1993)

In a long line of cases, we have held that, in addition to the specific freedoms protected by the Bill of Rights, the “liberty” specially protected by the Due Process Clause includes the rights . . . to direct the education and upbringing of one’s children.

The Fourteenth Amendment “forbids the government to infringe … ‘fundamental’ liberty interests of all, no matter what process is provided, unless the infringement is narrowly tailored to serve a compelling state interest.”

– Washington v. Glucksburg, 521 U.S. 702 (1997)

The liberty interest at issue in this case-the interest of parents in the care, custody, and control of their children-is perhaps the oldest of the fundamental liberty interests recognized by this Court.

In light of this extensive precedent, it cannot now be doubted that the Due Process Clause of the Fourteenth Amendment protects the fundamental right of parents to make decisions concerning the care, custody, and control of their children.

The problem here is not that the Washington Superior Court intervened, but that when it did so, it gave no special weight at all to Granville’s determination of her daughters’ best interests. More importantly, it appears that the Superior Court applied exactly the opposite presumption.

The Due Process Clause does not permit a State to infringe on the fundamental right of parents to make childrearing decisions simply because a state judge believes a ‘better’ decision could be made.

– Troxel v. Granville, 530 U.S. 57 (2000)