Secretary Tommy G. Thompson
U.S. Department of Health and Human Services
Attn: Privacy I
Hubert H. Humphrey Bldg., Room 801
200 Independence Ave., S.W
Washington, D.C. 20207

RE: Health Insurance Portability and Accountability Act Federal Privacy Regulations and Guidelines for Interviewing Children Alone

Dear Honorable Tommy Thompson,

I am writing to you today as a concerned mother and citizen about the implementation of the Final Rules as drafted by the U.S. Department of Health and Human Services by former Secretary Donna Shalala under the Clinton Administration.

Blue Cross Blue Shield of Michigan notified their agent force that minor children are able to exclude parents from obtaining medical information on their children. As disturbing as this is, I am more alarmed by a number of other issues that dramatically affect our children, families, and society.

  1. The Final Rules make it legal for a minor child to make medical decisions on their own, without parental consent or a legal representative. § 164.502 Uses and disclosures of protected health information: general rules. § 164.522(a) – Right of An Individual To Request Restriction of Uses and Disclosures
  2. The entities, as established by these rules, are legally responsible for communicating the privacy rights to individuals, which would include minor children. § 164.506(c)(4), § 164.501
  3. The American Academy of Pediatrics Guidelines for Health Supervision III, recommend that physicians interview children alone beginning at the age of twelve or as early as the age of ten, if it is comfortable for the child. [Page 82635] of the Final Rules for the Standards for Privacy of Individually Identifiable Health Information

When I took my daughter for a sport physical at the age of 13, the physician asked me to leave the room unless my daughter gave permission for me to stay. During the course of the exam, she asked my daughter if she was in need of contraceptive information. I asked the physician, if my daughter had said yes about contraceptive use would she have informed me about my daughter’s decision. The doctor indicated no, this falls under the category of doctor patient confidentiality.

Physicians, insurance companies, educators, and our public officials who implement practices and laws that undermine the family are overstepping their bounds. These entities are ignoring our personal religious beliefs, our family health histories and they are playing Russian Roulette with the lives of our children, they are destroying families, and the health care delivery system. Each parent must do their job to protect the children God has entrusted to them. Authority should not be handed over to children.


Cynthia M. Dudek