Adolescent Health Care, Confidentiality

Concerns about confidentiality may discourage adolescents from seeking necessary medical care and counseling, and may create barriers to open communication between patient and physician. Protection of confidentiality is needed to appropriately address issues such as depression, suicide, substance abuse, domestic violence, unintended pregnancy and sexual orientation.

When caring for an adolescent patient:

The physician should offer the adolescent an opportunity for examination and counseling separate from parents/guardians, and their privacy should be respected.
The physician should make a reasonable effort to encourage the adolescent to involve parents or guardians in healthcare decisions.
The physician should educate parents to encourage their adolescents toward personal responsibility in health care, and facilitate communication regarding appointments and payments, in a manner supportive of the adolescent's rights to confidentiality.
Every effort should be made to maintain confidentiality. The limits on what can be guaranteed should be clearly discussed. Information that would suggest someone is in danger, evidence of abuse or diagnosis of certain communicable diseases must be reported to the proper authorities.
Since state laws and regulations vary, family physicians should be aware of their community's standards regarding adolescent confidentiality. In general, especially in areas where the adolescent has the legal right to give consent, confidentiality must be maintained. Ultimately, the judgment of the physician should prevail in the best medical interest of the patient.

(1988) (2008)