Confidentiality for teens

The Society for Adolescent Medicine recently issued a position paper, Confidential Health Care for Adolescents with these recommendations:

Health providers should inform adolescent patients and their parents, if available, about the requirements of confidentiality, including a full explanation of what confidential care entails and the conditions under which confidentiality might be breached.

Health providers must remain flexible when delivering confidential care to adolescents. Blind adherence to absolute confidentiality is neither desirable nor required by ethics or law.

Health providers should develop a disclosure plan for those adolescents who are deemed not to have capacity to give informed consent or for whom disclosure of information to responsible adults becomes necessary.

Health providers must consider the manner in which written and electronic medical records might be available to other parties.

Expanded efforts are needed to increase the education of health professionals regarding the laws and regulations in their jurisdiction relating to confidentiality and informed consent for adolescents.

Further research is necessary to evaluate the process of maintaining confidentiality. These investigations should include studies of the attitudes of adolescents related to confidentiality, specific influences of gender and race/ethnicity, provider and parental attitudes about confidentiality.

(Sigman, G. Confidential health care for adolescents. J Adolesc Health 1997; 21(6):408-415)

COMMENT: For me, the most significant phrase is blind adherence to absolute confidentiality. I see far too much of this inhibiting two agencies from cooperating to aid a mutual client. -R.A.