Pregnant at 15: Some legal issues relating to treatment

TEENAGE PREGNANCY

Jay is 18 years old, a recent graduate from high school. He has been developing feelings for Janice, who is 3 years younger than him. Finally he had the courage to ask her out on a date. Their personalities are very compatible and they got along very well, leading them to develop into a committed, romantic relationship.

Jay and Janice usually go out on movie dates and take long walks in the park. As the days went on, they got closer with each other emotionally and physically, holding hands and hugging. Both of them started to become very fond of each other. They began to kiss passionately and fiddled with each other under clothing. They felt sexually aroused, and got more comfortable with touching and continued whenever they had the chance to.

One day, Jay went over to Janice’s house when her parents were not home. They decided to watch a movie and got carried away when they started kissing passionately, and doing the usual things they did. Jay suggested that they try to have sex. Janice thought about it and asked if he had protection.  Jay convinced Janice that it would be okay if they didn’t have any because every friend he knows who has sex has no problems without a condom. Janice was then persuaded and they went up to her room and had sexual intercourse.

A month or so later, Janice felt unwell and was nauseated. Janice suddenly remembered that her period did not come during the first week of the month, which was odd. Jay and Janice started to worry and bought a pregnancy test in the drug store. The test was positive. Janice was pregnant.
 

Janice, only age 15, decided that she should tell her parents. Her parents were furious and upset. Her parents wondered if abortion for young teenagers may be risky and dangerous, but insist that she abort anyways because they didn’t want to take care of her baby.

Janice wants to give birth to her baby.  At the same time, she is angry at Jay about the condom issue.

Teenage sexual activity and pregnancy: What the Law Says:

Q1: Was the sexual activity between Janice (age 15) and her boyfriend Jay (age 18) legal?

A: Yes.  Janice was old enough to legally consent to sex with Jay.

When are you old enough to legally consent to sexual activity?

If you are…

·                     12 or 13, you can consent to sex, but only with someone less than two years older than you.

·                     14 or 15, you can consent to sex, but only with someone who isless than 5 years older than you. But, you CAN'T consent to sex with someone who is more than two years younger than you (or you could be charged).

·                     16 and older, you can consent to sex with anyone older than you. 

·                     In all of these cases, however, if you are under 18, you cannot legally consent to sex with someone who is in a position of trust or authority over you (like your teacher, swim coach, Pastor). That person could be charged with a criminal offence.

Read the law: Criminal Code of Canada, s.150.1-153.

Q2: Can Janice go against her parents’ wishes and deliver the baby (instead of having an abortion)?

A: Yes. As long as Janice has the capacity to consent to medical treatment and understand her medical situation, she can make her own decisions around her pregnancy and the birth.

When are you old enough to make your own medical decisions?

In Ontario, your age does not determine your ability to make decisions about medical treatment. Instead, you can make your own decisions about your health care as long as you are considered capable by your doctor or health-care provider.  Being capable means that you can understand the information that you are given about treatment as well as the consequences of your decision (such as the risks and results of the treatment).  

Your doctor might consider you capable with respect to some treatments and decisions, but incapable with respect to others, depending on how complicated or risky those treatments are.  For example, the different treatments Janice can expect to hear about at the doctor’s office might range from a second pregnancy test to an ultrasound (a test to look at the fetus and see if it is developing healthily) to an abortion (a procedure to end the pregnancy).  All of these are treatments with different risks, so the doctor might decide that Janice is capable of making some of those decisions and not others. 

In Ontario, you are presumed to be capable of making medical decisions unless the doctor has a reason to believe that you are not capable.  Age can play a role in this decision, since the older you are, the more able you generally are to make independent decisions and understand the consequences of those decisions.  It’s always a good idea to ask the doctor before you discuss something with them, in order to make sure that the doctor will respect your rights and not tell your parents what you have said.

Since Janice is fifteen, the doctor will probably decide that Janice is capable of making most or all of her medical decisions.  Any decisions that Janice makes cannot be disclosed to her parents, unless Janice gives her express consent.  This means that the doctor must ask Janice before telling her parents about her health care information, decisions, and treatment, and Janice must tell the doctor that it is okay to tell.  Ideally, Janice would sign a “consent” form that states exactly what information the doctor may share, and who the doctor can share it with.

It is unlikely, but possible that her doctor may decide that Janice is incapable with respect to a certain treatment or medical decision.  For example, if Janice has a severe learning disability or a mental health condition that prevents her from being able to understand her medical issues and the treatment options, then the doctor may decide she is incapable.  In such a case, the doctor will then be able to disclose Janice’s medical information to someone called a “substitute decision-maker.”  Since Janice is under 16 and lives with her parents, this person would be one of her parents.  In this case, Janice will be able to discuss her situation with her parents, but they will be responsible for making her health-care decisions for issues where the doctor has decided Janice is incapable.

For more information about teen pregnancy, support, and health care options if you think you might be pregnant:

The June Callwood Centre is a multi-service centre for pregnant and parenting teens in Toronto.  Their website contains links to other resources (if you are planning to have a baby or make a decision about a pregnancy), as well as information about the resources they provide.

Rosalie Hall provides services for young women who are going to have a baby or who are new parents, including education, counseling and outreach, child care, among other programs.

Planned Parenthood Toronto provides health care and health services to youth, including on sexual and reproductive health issues, and they will provide information and pregnancy-related medical treatment, including pregnancy tests, counselling on pregnancy options, and referrals to services to help pregnant women make an informed decision regarding pregnancy.

The Ontario laws that determine who can make medical decisions and how medical information can be released are the Health Care Consent Act and the Personal Health Information Protection Act.

The scenario for this post was written by Ying Yi Lau, a volunteer member of the PLE Team.  The legal info was written by JFCY. 

Teen Pregnancy - Part Two (non-medical decisions)

Kiran and her boyfriend Rick are fifteen years old and in grade ten.  They have been dating for several months and spend most of their time together.  They care about each other and trust each other very much.  A few months into their relationship, Kiran and Rick felt ready to begin having a sexually intimate relationship. 

Kiran has a lot of questions about sex and the emotions that she is feeling but she has only discussed her relationship with her peers at school.  She has not told her parents or her doctor about her sexual relationship.  She is afraid that if she tells her parents she will get in trouble.  She also believes that she cannot see a doctor without her parents’ permission and if she does see a doctor, she is afraid they will tell her parents what they have discussed.

Since Kiran has not spoken with a doctor, she is not using any methods of birth control, (such as the birth control pill) other than condoms.  Both Rick and Kiran are shy and embarrassed to buy condoms in the store, so they only use condoms when Rick asks his older brother. 

This month Kiran missed her period and thinks she might be pregnant.  She and her friend go to the pharmacy and purchase a pregnancy test.  When she takes the test she sees a positive result, indicating that she is pregnant.  Kiran is overwhelmed, scared and doesn’t know what to do next.  What are her options?  What are her rights?

There are two parts to Kiran’s decision-making about the pregnancy: medical decisions, and non-medical decisions (like adoption, involving Rick in the pregnancy, and supporting a baby).  Last week’s post covered Kiran’s medical rights and decisions – today’s post is about her non-medical decisions and providing care for a baby.  This post does not include information about receiving financial support, such as government benefits or child support, for a baby.

If Kiran decides to carry her fetus to term, there are a number of decisions to consider.  She will have to think about whether she wants to raise a baby or put the baby up for adoption, what kind of parenting the baby will have, and how the baby will be supported.  While Kiran is pregnant, Rick has no legal rights to be involved with her pregnancy.  After the baby is born, both parents have legal rights regarding the baby.

Adoption: Legal Issues

If Kiran and Rick both do not want to raise the baby, they have the option of putting the baby up for adoption.  In an adoption, another person or people will raise the baby, and take on the legal responsibilities relating to the baby.  In Ontario, both parents must give their consent in order for an adoption to occur – this means that Kiran and Rick must both agree that an adoption is the right decision for them and for the baby.  The baby must be at least one week old before they can make this decision, and since both parents are under 18, a government lawyer (called the Children’s Lawyer) must confirm that each one understands the decision he or she is making and genuinely wants to give consent.

After Rick and Kiran have given their consent for an adoption, they may still change their minds and withdraw consent for up to 21 days following the initial decision.  Sometimes this time can be extended, but only if the baby has not yet been placed for adoption.

When the baby is put up for adoption, the Children’s Aid Society or a licensed private agency will take responsibility for placing the baby and ensuring that its new home and parents will be able to care well for it.  Kiran and Rick will still have input into what kind of home they would like the baby to be placed in, but it is the family that will best meet the needs of the baby that will be chosen as the adoptive parent(s).  The only exception to this is if a relative, like Kiran’s parents, choose to adopt the baby. 

After an adoption, biological parents like Kiran and Rick are normally not involved in the baby’s life and they will not have access to the baby.  Sometimes, adoptive parents will agree to an “openness agreement.” This agreement would allow Kiran and/or Rick to communicate with the adoptive parents, or to share pictures or letters as the child grows up.  However, the details of this agreement would have to be negotiated, and the adoptive parents are the ones who have full legal rights to the child.  Kiran and Rick can also make decisions about whether and how their biological child can contact them in the future as an adult.

Click here for information about adoption in Ontario (government website)

Click here for information about access to adoption records in Ontario (government website)
Adoption law in Ontario is found in the Child and Family Services Act

Custody and Access: Legal Issues

If Kiran decides to raise the baby, she will have to work with Rick to make decisions about “custody” and “access.”  Having custody of a child means having the right to make important decisions about raising the child – things like school, religion, and health care.  One or both parents can have custody, but if a parent does not have custody, he or she may still have access to the child.  This means that both parents get to see the baby and have a relationship with it.  A parent who does not have custody also has the right to access custody-related information about the child, even if he or she doesn’t have the right to make those decisions.

Kiran will have to work with Rick, preferably with the help of a lawyer, to make decisions about custody and access.  There are many possibilities for arranging custody and access, but the most important thing to consider is the best interest of the baby.  For example, this could mean that the baby will live at Kiran’s house and spend the most time with Kiran if she is breast-feeding.  Rick would come to Kiran’s to visit the baby.  This arrangement could change as the baby grew older.  It is very rare that the court will refuse to allow one parent access to his or her child, although it is possible to put conditions on parental access.  As always, the most important thing is the child’s best interest.

When Kiran and Rick have agreed about access and custody, they will sign agreements that contain their decisions.  It is possible for Kiran and Rick to raise the baby without written custody and access agreements, but having these agreements will make sure that everyone knows who is responsible for what and who has what rights, so that arguments will be less likely.  When there is a written agreement, it can be enforced by a court.  In order to change custody and access decisions, the written agreement must also be changed.

If Rick and Kiran cannot agree about custody and access, they may work with a mediator.  A mediator is someone who helps work through disagreements in order to achieve a result that both parents are happy with.  If they are still unable to agree, they may go to court, where a judge will make an order about custody and access.  Both Rick and Kiran will have to follow the judge’s order.  If they want to change the order, they will have to go back to court.

Click here for a pamphlet on custody and access (external link – Your Legal Rights)
Law about custody and access in Ontario is found in the Children's Law Reform Act

Caring for a baby: When would CAS get involved?

Raising a baby can be scary for young parents, since they have a lot of new responsibilities.  While young people can be great parents and take good care of their new baby, sometimes there is concern about whether the baby is getting all the care and support that it needs.  In this situation, a Children’s Aid Society (CAS) or another child welfare organization will become involved with the family.  Since Kiran and Rick are teen parents, CAS may become involved with them and their baby right from the birth.  If Kiran or Rick was ever involved with CAS before, this is more likely to happen.

If CAS is concerned about Kiran and Rick’s baby, they will investigate.  There are certain rules that they must follow in this investigation in order to make a decision about what should happen next.  They may decide that they do not need to be involved with the family, or that the family needs extra support.  They may also decide that the baby is in need of protection, in which case they can remove the baby from Kiran or Rick’s care.  As in the case of custody and access, the most important consideration will be the best interests of the child.

If the baby is removed from its parents, there will be a child protection hearing in court soon after.  At this hearing, the court will make a decision about next steps.  The court will only keep the baby from Kiran and Rick if the court believes the baby is likely to suffer harm and can’t be protected through other means, like putting conditions on the parents'care.

If CAS becomes involved with Kiran and Rick, it is very important for them to have legal support.  Sometimes CAS involvement can lead to a parent's right of custody and access being terminated completely.  Kiran and Rick should each contact a lawyer to help them understand and protect heir parental rights throughout CAS’s involvement.

Click here for a pamphlet on child protection (external link – Your Legal Rights)
Child protection law in Ontario is found in the Child and Family Services Act

Having a baby is an important and life-changing decision, and there are lots of legal issues involved with raising a child as a young person or a person who is not living with the child’s other parent.  If you have specific questions or a personal situation, you should contact a lawyer for legal advice.  If you are a young person in Ontario and you need a lawyer to represent you, you can call Legal Aid Ontario: (416)598-0200, 1-800-668-8258 (outside GTA), or Justice for Children and Youth (416) 920-1633, 1-866-999-5329 (outside GTA)

Teen Pregnancy - Part One: Medical Decisions

What does the law say about a youth's right to make health-related decisions?

Kiran and her boyfriend Rick are fifteen years old and in grade ten.  They have been dating for several months and spend most of their time together.  They care about each other and trust each other very much.  A few months into their relationship, Kiran and Rick felt ready to begin having a sexually intimate relationship. 

Kiran has a lot of questions about sex and the emotions that she is feeling but she has only discussed her relationship with her peers at school.  She has not told her parents or her doctor about her sexual relationship.  She is afraid that if she tells her parents she will get in trouble.  She also believes that she cannot see a doctor without her parents’ permission and if she does see a doctor, she is afraid they will tell her parents what they have discussed.

Since Kiran has not spoken with a doctor, she is not using any methods of birth control, (such as the birth control pill) other than condoms.  Both Rick and Kiran are shy and embarrassed to buy condoms in the store, so they only use condoms when Rick asks his older brother. 

This month Kiran missed her period and thinks she might be pregnant.  She and her friend go to the pharmacy and purchase a pregnancy test.  When she takes the test she sees a positive result, indicating that she is pregnant.  Kiran is overwhelmed, scared and doesn’t know what to do next.  What are her options?  What are her rights?

There are two parts to Kiran’s decision-making about the pregnancy: medical decisions, and non-medical decisions (like adoption, involving Rick in the pregnancy, and supporting a baby).  This week’s post covers Kiran’s medical rights and decisions – part two will talk about her non-medical decisions.

Medical decisions

In Ontario, your age does not determine your ability to make decisions about medical treatment. Instead, you can make your own decisions about your health care as long as you are considered capable by your doctor or health-care provider.  Being capable means that you can understand the information that you are given about treatment as well as the consequences of your decision (such as the risks and results of the treatment).  

Your doctor might consider you capable with respect to some treatments and decisions, but incapable with respect to others, depending on how complicated or risky those treatments are.  For example, the different treatments Kiran can expect to hear about at the doctor’s office might range from a second pregnancy test to an ultrasound (a test to look at the fetus and see if it is developing healthily) to an abortion (a procedure to end the pregnancy).  All of these are treatments with different risks, so the doctor might decide that Kiran is capable of making some of those decisions and not others.  In Ontario, you are presumed to be capable of making medical decisions unless the doctor has a reason to believe that you are not capable.  Age can play a role in this decision, since the older you are, the more able you generally are to make independent decisions and understand the consequences of those decisions.  It’s always a good idea to ask the doctor before you discuss something with them, in order to make sure that the doctor will respect your rights and not tell your parents what you have said.

Since Kiran is fifteen, the doctor will probably decide that Kiran is capable of making most or all of her medical decisions.  Any decisions that Kiran makes cannot be disclosed to Kiran’s parents, unless Kiran gives her express consent.  This means that the doctor must ask Kiran before telling Kiran’s parents about her health care information, decisions, and treatment, and Kiran must tell the doctor that it is okay to tell.  Kiran would sign a “consent” form that states exactly what information the doctor may share, and who the doctor can share it with.

If the doctor decides that Kiran is incapable with respect to a certain treatment or medical decision, then the doctor will be able to disclose Kiran’s medical information to someone called a “substitute decision-maker.”  Since Kiran is under 16 and lives with her parents, this person would be one of her parents.  In this case, Kiran will be able to discuss her situation with her parents, but they will be responsible for making her health-care decisions for issues where the doctor has decided Kiran is incapable.

For more information about teen pregnancy, support, and health care options if you think you might be pregnant:

The June Callwood Centre is a multi-service centre for pregnant and parenting teens in Toronto.  Their website contains links to other resources (if you are planning to have a baby or make a decision about a pregnancy), as well as information about the resources they provide.

Rosalie Hall provides services for young women who are going to have a baby or who are new parents, including education, counseling and outreach, child care, among other programs.

Planned Parenthood Toronto provides health care and health services to youth, including on sexual and reproductive health issues, and they will provide information and pregnancy-related medical treatment, including pregnancy tests, counselling on pregnancy options, and referrals to services to help pregnant women make an informed decision regarding pregnancy.

The Ontario laws that determine who can make medical decisions and how medical information can be released are the Health Care Consent Act and the Personal Health Information Protection Act.

Scenario by JFCY Volunteer Marsha Rampersaud.  Legal information by JFCY.