By MELISSA KANG
If your teenage daughter was sexually active and wanted to go on the pill, you’d want to know, right? Well, think back to when you were her age – would you have told your parents?
These questions were the subject of a recent Melbourne study of parental views of adolescent’s right to confidential health care.
The study, which took place in a specialist Adolescent Medicine clinic, found the majority of parents surveyed (86%) believed they should be informed by their adolescent’s treating health professional about their health problems and behaviours, regardless of whether their child agreed.
For clinicians, confidential care underpins best practice in adolescent health. But so does working with parents and families to support young people who have health problems.
These seemingly opposite approaches raise a number of ethical, legal and health-care issues for health professionals who treat young people.
In Australia, confidential health care is a human right enshrined in law. And medical practitioners can be sued for breaching patient confidentiality.
There are many exceptions to this, such as a patient giving permission for their information to be shared – with partners, parents or family members – or when a person is deemed at serious risk of harm to themselves or others.
If a child under 16 years is considered to be at risk of harm then health professionals are mandated by law to notify child protection authorities (except Western Australia, where health professionals are only required to report sexual abuse).
The definition of “risk of harm” varies between jurisdictions, as does the classification of who constitutes a “mandatory reporter”.
While there are many other legal exemptions to confidential health care, these are the most pertinent in the day-to-day clinical care of adolescent patients.
In practice, this means that a teenager who sits in a consulting room with his or her doctor can rely on their doctor to keep confidential any information they disclose unless an exemption applies.
How old is old enough?
There is no lower age limit, and this is the case if the young patient has presented themselves to a health service independently, or if they see you while mum or dad waits in the waiting room.
So imagine Maya, aged 15, nervously attending the family GP by herself for the first time, worried about pregnancy following an unprotected but consensual sexual encounter two days earlier with her 15-year-old boyfriend of several weeks.