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PARENT HAS DUTY TO KEEP CHILD HEALTHY . . .

SHARE PARENT HAS DUTY TO KEEP CHILD HEALTHY . . .

The current argument over parental consent for adolescent drug testing encompasses far more than a theoretical debate over an adolescent's right to privacy versus a parent's right to know. It centers on parents' real need to safeguard their children from the dangers of drugs.

As a practicing clinical social worker for more than 20 years, I have watched hundreds of youngsters and their families struggle with the tragedies of drug abuse and addiction.I am confident that many of those young people could have been deterred from continued drug abuse if a caring, firm parent had insisted early on that they submit to a urine test instead of waiting for the condition to deteriorate.

In a program like the Cobb County Adolescent Drug Screening Program in Georgia, a sample is given in the privacy of the family home and submitted anonymously - only the parent need know for sure to whom the urine belongs. The program currently is in operation in 16 Georgia hospitals, and another, based on the Georgia model, is set to open in a suburban Boston hospital in the fall.

In other programs, parents may request their child's pediatrician to run the urine screen.

The stakes are high for adolescent drug use and the consequences often are permanent - diminished capabilities; inadequate education; unwanted pregnancy; depression; accidents; suicide attempts and sometimes even death.

Parents who suspect that their child is involved in behavior with such serious potential consequences have not only the right, but the obligation, to employ urine testing.

A 1989 Gallup poll confirms that the majority of U.S. adults and teens agree: 65 percent of adults and 80 percent of teenagers believe that high school students should be tested for drugs. Clearly, they believe discovery is critical.

No one ever begins to use drugs with the goal of becoming an addict. The predominant attraction is simply in most cases an intent "to have fun." Denial of the risks involved is characteristic of users - especially adolescents.

That a professional medical association has a policy that fails to recognize this and appears to be more concerned about privacy rights of adolescents than about the parental right to know about a health matter as serious as substance abuse says more about the framers of the policy than it does about the policy itself.

In the August 1989 issue of "Pediatrics" the American Academy of Pediatrics stated: "If screening were conducted in a completely confidential manner, with only the physician and the patient knowing the results and the only consequences of a positive test result being efforts toward intervention, there might be little or no risk to the person being screened."

This statement ignores a critical fact that pediatricians should understand - almost no one ever goes into drug treatment voluntarily. Thus, unless the physician is in a position to insist on the patient's treatment and to support it, genuine risk to the adolescent patient lies in not notifying the parent - the one person who can most likely initiate care.

The logical question that anyone familiar with addiction might ask after reading the AAP policy statement is this: Which is greater - the risk of privacy violation or the risk of not being screened and thereby continuing addiction?

In my mind, there's no contest about which risk is greater.

A parent has the right - and the responsibility - to find out if his or her child has a life-threatening disease.

What the controversy over adolescent drug screening - especially the Georgia program - reveals is quite clear: Many in the medical community are uninformed about the disease of addiction.

Doctors, like some others, tend to lump addiction into the categories of strictly legal or moral issues. In reality, drug dependence in adolescents is an issue of healthy growth and development. Fostering that growth and development is a parental responsibility that pediatricians should assist.

When was the last time that anyone heard of a physician objecting to a test for diabetes? Or tuberculosis? Both are progressive diseases that ultimately can kill. So is addiction.