Posted on: Friday, February 1,2002
State hospitals requiring OK for minor's abortion
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By Alice Keesing
Advertiser Health Writer
Minors must have the consent of their parents to get an abortion at Hawai'i's 12 state hospitals, under a new policy implemented by the managing company.
Critics say it means girls, particularly those on the Neighbor Islands, will have fewer choices. But the Hawai'i Health Systems Corporation says it is treating abortions like any other medical procedure that requires parental consent.
The new policy, which took effect Jan. 14, requires HHSC's 12 hospitals to obtain consent from a parent or legal guardian before performing an abortion on girls younger than 18 who are not married.
A lawyer for HHSC said the hospitals do very few abortions on minors.
Last year, a bill requiring doctors to notify minor's parents before an abortion was buried at the Legislature; the move by HHSC promises to reignite the debate.
HHSC legal counsel Alice Hall said the policy was introduced to end confusion over what the law requires for abortions to minors. It also is to shield hospitals from being sued by parents, she said.
"It's not any kind of a position for or against abortions — we do abortions — we're just requiring that there be informed consent like there is for other surgery," Hall said.
'Totally inappropriate'
But the policy has drawn the ire of Planned Parenthood of Hawai'i, which believes it reduces the options for girls, particularly those on the Neighbor Islands, where HHSC hospitals can be the only choice. Chief executive officer Barry Raff said it could ultimately drive teens underground to get illegal abortions.
Raff said he found out about the policy this week when he was contacted by Hilo Hospital staff who were worried about the new rule.
"We absolutely plan to respond," Raff said. "We think it's totally inappropriate for a state entity to implement a parental consent law when there is no Hawai'i law that requires that."
Raff said he's not sure what the response will be, but that he is working with local and national agencies on the issue.
"I assume we're going to have a demand letter to them to cease and desist, and we may have to go further into legal action if that doesn't happen," he said.
Most agree that the issue of parental consent is a cloudy one. An opinion from the attorney general's office last year found no clear guidelines.
However, Senate Health and Human Services Chairman David Matsuura yesterday said he reads that opinion to indicate that Hawai'i law does require parental consent. Therefore, he said, there is no need to hear another bill this year.
Raff disagreed, saying the issue has yet to be decided in court.
And Hall said HHSC made its decision to end the confusion in hospitals based on the fact that state law in general requires parental consent for any medical treatment.
"There is no law that requires us to even do abortions, let alone do them on minors, so we felt that the best way to proceed was to follow the general rule that you need parental consent," she said.
House Health Committee Chairman Dennis Arakaki said he would want to be notified if any of his three daughters sought an abortion as a minor, but isn't sure the hospital corporation should have adopted its new policy.
"As a public entity, I'm really surprised they would take that position," said Arakaki, D-28th (Kalihi Valley, Kamehameha Heights). "An important policy issue like that, I think that should be left up the the Legislature."
Arakaki said several bills were introduced this year dealing with the parental consent issue, but he does not plan to hold hearings on any of them.
Options debated
There were 935 teen abortions in Hawai'i in 2000. Raff said HHSC's new policy could leave some pregnant girls with nowhere to go. Doctors usually won't perform abortion in their offices after 10 weeks and some girls will not be able to get parental consent to go to an HHSC hospital, he said.
"Some of them come from abused homes, for some of them it's a question of incest ... some of them their parents aren't even around," he said.
Hall disagreed, saying there are other options. HHSC also canvassed its hospitals while preparing the policy and found that they are doing very few abortions on minors, she said.
HHSC was established as a public benefit corporation by the Legislature in 1996 to manage the 12 hospitals that were previously under the Department of Health. The state-attached agency generates its own revenue but also receives a state subsidy of between 3 and 5 percent.
It manages the following hospitals: Hilo Medical Center, Hale Ho'ola Hamakua, Ka'u Hospital, Kona Community Hospital, Kohala Hospital on the Big Island; Maui Memorial Medical Center, Kula Hospital and Lana'i Community Hospital in the Maui region; Maluhia and Leahi Hospital on O'ahu; and Kaua'i Veterans Memorial Hospital and Samuel Mahelona Memorial Hospital on Kaua'i.
Advertiser staff writers Kevin Dayton and Lynda Arakawa contributed to this report.
Reach Alice Keesing at akeesing@honoluluadvertiser.com or 525-8014.
