Mn577 discussion board peer response: state laws and adolescent

 

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An adolescent’s concerns about privacy can prevent them from seeking primary health care, especially for specific sensitive health care services such as STI screening and family planning issues. Those with privacy concerns are also less likely to talk openly with a health care clinician about important health issues, such as substance use, mental health, and risky sex. Recognizing that confidentiality is critical to high-quality care for adolescent women, professional health care organizations have adopted policy statements and practice guidelines that support the provision of confidential services. 

Discuss these guidelines and the laws in your state that address adolescent confidential health care.

Peer Response 1

 

This is a great discussion topic, because I have often thought about adolescent care and confidentiality, but have never gotten the chance to thoroughly investigate the topic. I have worked with adult populations and therefore it has never been a big issue in my professional career. We all know that adolescent brains are not fully developed and they require teaching, support and valid resources when they encounter problems in their lives. This is why laws were enacted to allow adolescents to see a provider confidentially and seek medical help from a professional without the repercussions from their parents who may disapprove of their actions or situation.

            In my state of Idaho, mental health services are confidential for adolescents after the age of 14 and cannot be shared with the parents without written consent of the adolescent unless they need to disclose information in order to bill insurance, carry out a treatment plan or prevent harm to the child or others or if they are ordered to by a court of law (Children’s Mental Health Services, 2018). Therefore, the clinician does have quite a bit of wiggle room in the statue because a majority of mental health issues can result in harm to the child or others. Either way, it’s good to understand that the age of 14 is the deciding factor. After 18 though, it is all confidential and no parents have rights to the individual’s medical records.

            

As for medical information. Every state allows adolescents to be seen, screened and treated for sexually transmitted infections and diseases without release of information to the parents. This law was passed as research was conducted that indicated that adolescents were MUCH less likely to seek medical help for STD’s if they knew their parents would find out. Therefore, in an attempt to decrease the prevalence of STD’s, no parental consent or notification is necessary (Bornstein, 2000). Even though confidentiality is attempted in this population with sensitive sexual or reproductive issues, obstacles to patient privacy remain. Overall, from what I can find, the provider in Idaho has the discretion to notify parents of any medical information of an adolescent.

Peer Response 2

 

When it comes to healthcare, Patient’s confidentiality is paramount, a sensitive issue, and is part of the law in many states.  When caring for adolescent patients, care is not any different.  If a minor is seeking care and fears his or her information would be disclosed to their parents, it might prevent them from seeking preventative care such as contraceptives, pregnancy testing, sexually transmitted infection testing, or even psychological help if needed.  Unless, the provider suspects neglect or abuse, confidentially should always be provided to adolescents.  Judgement by the provider regarding the best medical interest and safety of the patient should prevail (AAFP, 2013). 

In the state of Florida, the Florida Legislature (2017) there are some cases a minor could consent for their own care without a parent’s consent.  For example, if the minor is not married and pregnant or a mother, she could consent for herself and for her child; if the minor is seventeen years-old he could consent for blood donation; also, contraceptives and services of a nonsurgical nature; confidential medical services and counselling related to substance abuse and mental health outpatient counselling and treatment to minors, that does not need medications and other somatic treatments or less than two outpatient visits.

Healthcare providers must be familiar with their federal and state laws related to adolescent consent and confidentiality.  Respecting adolescent patient’s rights and privacy is essential, but as a provider encouraging the adolescent seeking care to talk to their parents regarding their health could promote better communication between child and parents.  In some facilities, the provider may make a verbal contract with the parents and teenager regarding confidentiality.  This would assure the patient that any information obtain during the visit will remain in strict confidence unless the provider thinks it could pose a danger to the patient or if the patient themselves want to share the information with their parents. 

Ultimately as a healthcare provider, it is important to protect patient’s privacy and confidentiality but, at the same time, we must be aware that in all states, a person needing emergency medical treatment they may be treated without consent if securing a consent would delay treatment and places the patient’s life or health at risk (Olson and Middleman, 2018).  Patient care should not be delayed under any circumstances that will pose harm to the patient or cause death.   

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