All 50 states have statutes in place mandating that any healthcare worker must report reasonable suspicions of child sexual abuse to a designated law enforcement or child protective services agency.
In February and March of 2002, Life Dynamics conducted a nationwide undercover phone survey of Planned Parenthood and National Abortion Federation facilities. Our goal was to document their level of compliance with these state-mandated reporting statutes. This was not a random survey but a universal one. We identified 906 facilities in the U.S. as being associated with one or both of these organizations and we attempted to contact each one. Some were no longer in operation and others used one appointment line to service multiple facilities. In the end we were able to contact representatives of 813 of the original 906, including facilities in every state except Mississippi.
Our caller portrayed a 13-year-old girl who was pregnant by a 22-year-old man and wanting an abortion in order to conceal this sexual relationship from her parents and the authorities. In every call the ages of both the girl and the man she was involved with were introduced into the conversation and, in virtually every case, repeated at least once. Additionally, the caller never said anything to suggest that her parents would become violent or abusive if they discovered her sexual activity. It was always made clear that the motivation for the abortion was to conceal this sexual activity.
To document our investigation we made recordings of all 813 calls. (In Texas it is legal to record telephone conversations as long as one party to the conversation is aware of the recording.) Included here are the actual recordings of these calls accompanied by written transcripts. In order to accurately evaluate them, it is essential to understand the following principles:
(1) Because underage girls are not legally capable of giving consent for sexual activity, any sexual activity by an underage girl is, by definition, without her consent. On its face, that is reasonable suspicion of child sexual abuse.
(2) Seeking an abortion, pregnancy test, birth control (condoms, pills, etc.), or treatment for a sexually transmitted disease (STD) is evidence of sexual activity. Therefore, whenever any of these services are sought by a minor, a reasonable suspicion of child sexual abuse is created and the state-mandated reporting requirement is triggered.
(3) The responsibility for determining whether the circumstances of a child’s sexual activity are criminal or not lies solely with the state. Healthcare workers have no legal authority to investigate the incident, make assumptions about it, or draw conclusions about it. Therefore, anything the girl or anyone accompanying her (including parents, guardians, or relatives) says about the situation is totally unrelated to the healthcare worker’s legal obligation under the reporting statute. An analogy is the situation in which someone is brought into a hospital emergency room with a gunshot wound. The circumstances of this incident may or may not be criminal, but it is not the healthcare worker’s place to make that determination. His or her only role is to report the incident to the authorities and this duty does not change regardless of what the patient says. The same thing applies here.
(4) Patient confidentiality and the physician-patient privilege are irrelevant because (a) physicians are legally immune from civil or criminal penalties for violating patient confidentiality or the physician-patient privilege when they report suspicions of child sexual abuse, and (b) the authorities can investigate reported suspicions of child sexual abuse by speaking to the victim and other witnesses without the physician being involved. (These principles are well known among abortion providers. At Life Dynamics, we have a recording of Planned Parenthood’s corporate legal counsel advising a national convention of their affiliates that the obligation to comply with mandated reporting laws supercedes patient confidentiality in every state and in every circumstance.) It should also be remembered that law enforcement entities routinely secure patient medical records when conducting investigations involving possible illegal activities at nursing homes, Medicare and Medicaid violations, insurance fraud, etc.
(5) The fact that a minor girl may be lawfully allowed to secure an abortion, pregnancy test, birth control, or STD treatment without parental knowledge is unrelated to mandatory reporting. Remember, mandatory reporting deals with reports made to the state not to parents. In effect, a healthcare worker’s duty to a minor child or that child’s parents is a separate issue from their duty to the state.
(6) A healthcare worker’s duty to report to the state about the possible sexual abuse of a child does not prevent, interfere with or even delay that child’s ability to access these services since, in virtually every case, the report will not be made until after the service has been rendered. Again, the only relevant issue is that, when a minor seeks these services, that is evidence of sexual activity by someone who is not old enough to consent to sexual activity. At that point, a reasonable suspicion of child sexual abuse exists and, once that legal threshold is crossed, a report to the state is mandated.
In evaluating these calls, be aware of conversations in which the caller was:
given advise on how to avoid detection by parents or authorities
told what she should say or not say when she came to the clinic
encouraged to lie about or conceal her age or her boyfriend’s age
told to give fictitious names, phone numbers or address
instructed to be more careful about what information she gave out and to whom
ignored or interrupted when introducing her age or the age of her boyfriend
warned that if someone found out about this situation her boyfriend could go to jail
told to go elsewhere because she had already provided them too much information
told that the ages of the parties involved are irrelevant
told that the facility has no interest in her age or the age of her partner
told that they do not verify ages or check IDs and would accept what she told them
told to just keep her mouth shut at the clinic and no one would ask any questions
Sometimes, the misdeeds of the facility are purposely subtle. In addition to the issues already mentioned, be on alert for calls in which:
after identifying the situation as illegal and/or statutory rape, the clinic worker subsequently agrees that the facility will conceal the crime
after saying that they are “technically” or “legally” required to report this situation to the state, the clinic worker reassures the caller that the facility will not report
after identifying the situation as illegal and/or statutory rape, the clinic worker agrees to facilitate the ongoing criminal activity by providing birth control without making a report; our caller is often told that her boyfriend can come with her to pick up the birth control or that he can even pick it up without her being there; in other words, despite having evidence that a sexual crime is being committed against a 13-year-old child, they are willing to conspire with the perpetrator to cover-up the crime and then offer to provide him the means by which he can continue the abuse (birth control with no report)
the clinic worker initially expresses concern for the child, and may even suggest parental involvement, but in the end agrees to violate the law and conceal the situation
the clinic worker handles the call like a matter of routine, clearly indicating that the clinic encounters this situation frequently, and that they deal with it by ignoring the mandated reporting laws; one example of this are those calls in which this girl’s circumstances appear to have little or no impact on the clinic worker’s response
there is no response to the danger that the child is in, even though the facts of a statutory rape are clearly presented
the child’s dilemma is not addressed, with the sale of the service obviously being the clinic worker’s paramount concern
statements such as, “The way we handle these cases is …” signal that (a) the situation is common, and (b) the clinic worker is stating clinic policy not her own personal approach (this is especially relevant when the clinic worker puts the call on hold, conferred with someone else, then came back and agreed to conceal the situation)
the failure to report is justified by making it sound as though it is in the best interest of the child to “keep all this confidential”
the failure to report is justified by demeaning or discounting the influence of parents or the authorities
statements by the clinic worker are carefully worded in order to insulate them against claims of failing to report
even among clinic workers who display discomfort or concern with the situation, they continue to sell the service
when confronted with the dilemma of reporting, they advise the girl to go to another facility and then advise her what to say or not say at that facility in order to work around the reporting requirement
In states with parental involvement legislation in place, abortion proponents always justify the need for a judicial bypass option in order to address the so-called “hard cases” in which minors will be abused if forced to inform their parents about their pregnancies. However, our investigation documented that this is not the way it is actually being used. Instead, it is being automatically suggested to any underage girl who simply doesn’t want to tell her parents for any reason whatsoever or for no reason whatsoever. In the case of our caller, this was true despite the fact that she never said anything to indicate that her parents would become abusive or violent over this situation. And remember, in this specific incident, judicial bypass was not being introduced as a way to keep the child from being abused in the future, it was being introduced as a way to cover-up the fact that the child was already being abused.
If you are in a state with parental consent legislation, be aware of situations in which the caller was:
told about judicial bypass at the moment she stated that she didn’t want to tell her parents and before she had given any legitimate reason why she didn’t want to tell them
reassured about how quick and simple the judicial bypass process was
advised that, during the judicial bypass hearing, it would be best not to mention the age of the person who got her pregnant or lie to the judge if he asked about it
advised to go to another city where the judges are “more cooperative” with judicial bypass
given specific advise for circumventing parental involvement legislation such as letting her boyfriend or another adult take her out of state without her parents knowing about it
When we began releasing this information to the public, some of our opponents said that all we uncovered was a few rogue employees who were operating outside of Planned Parenthood or National Abortion Federation guidelines. Remember, however, that this was not a random survey but a universal one. We called every Planned Parenthood and National Abortion Federation facility in the country and made contact with almost every one. Under those circumstances, it is preposterous to suggest that when 90 percent do one thing and 10 percent do the opposite, it is the 90 percent who are in violation of the organization’s accepted and normal standards of behavior. The only logical conclusion is that the responses we received are the standard policy and practice of these organizations.
Another contention made by these groups is that our investigation simply reflects the fact that when their counselors have a sexually active underage girl on the phone they say whatever is necessary to get her into the clinic. The claim is that once she’s actually at the facility they will report her regardless of what they told her over the phone.
Anyone who listens to the tapes of these calls will find that assertion just as farfetched as the one about rouge employees. It is true that almost 10 percent of the Planned Parenthood and National Abortion Federation facilities we surveyed said they would obey the mandatory reporting laws, and in those conversations there were times when it appeared that the counselor was indeed trying to either lure the caller into the facility or get enough information to make a report. However, when you listen to the other 90 percent, what you find is that virtually nothing is said that could even be remotely construed as an attempt to get the girl to the facility so a report could be made. In fact, almost everything that was said during those conversations would work against that objective.
That was especially apparent in calls where they suggested practical steps for her to take that would effectively eliminate any possibility of a report being filed. For example, there are calls in which they said it would be best for her to lie about her age, name or address when she came to the clinic. Some employees went so far as to reassure her that the clinic does not check IDs or verify ages. Sometimes, while she would be giving details about her situation, the counselor would interrupt and tell her not to say anymore or repeat that information. Others told her that she had already revealed too much for their clinic to be able to help her and suggested that she go to another facility and not give them so much information.
Obviously, none of this is the kind of rhetoric someone would use if they were earnestly trying to get this girl into their clinic to make a report. Instead, it was clear that what they were doing is giving her a “heads-up” and some of these counselors actually made that very point during the call.