that the legislative intent behind consent to treatment—to promote individual and public health while preserving confidentiality—should similarly apply to research.

Moreover, it is important to note that where the law is silent on the issue (e.g., the applicability of treatment consent by minors to research consent), silence does not imply impermissibility. In fact, it could be argued that actions are permissible unless they are specifically restricted by the courts or legislative actions [31].

Alternatively, of course, it should be noted that there is an important distinction between research and treatment. The former seeks to build generalizable knowledge without a focus on individual benefit, whereas the latter focuses on individual well-being. Accordingly, inasmuch as their intents vary, so too might the legal protections for children and adolescents attached to research versus treatment justifiably vary. Federal regulations also note that “assent,” the child’s “affirmative agreement to participate in research,” is required when IRBs determine that children are capable of such, thus leaving much to the IRB’s discretion [33]. This imprecision in federal regulations has not been addressed by the states [34].

Finally, it is also worth clarifying the distinction between emancipation and mature minor status, a distinction not always clearly made in state law.¹² In general, emancipation (in this appendix) confers broader “adult” status to youth in all aspects of their lives, whereas the attainment of “mature minor” status is more narrowly construed in terms of the sort of health care consent authority that it confers. These differences might similarly affect the reach of regulations on research with minors, or at least the requirements to consent to research. “Emancipated minors,” to whose lives events have conferred—in the eyes of the state—legal adulthood, should be able to consent to research as adults.¹³ “Mature minors,” on the other