Consent in adolescent health care
- Kelly A Olson, MD, MA
Kelly A Olson, MD, MA
- San Jose Clinic
- Amy B Middleman, MD, MPH, MS Ed
Amy B Middleman, MD, MPH, MS Ed
- Section Editor — Adolescent Medicine
- Professor of Pediatrics, Chief of Adolescent Medicine
- University of Oklahoma Health Sciences Center
- Section Editors
- Abigail English, JD
Abigail English, JD
- Section Editor — Adolescent Medicine
- Director and President
- Center for Adolescent Health & the Law
- Diane Blake, MD
Diane Blake, MD
- Section Editor — Adolescent Medicine
- Professor of Pediatrics
- University of Massachusetts Medical School
The concepts of informed consent and confidentiality are complex when the patient is an adolescent. This is particularly true when the needs and wishes of the adolescent conflict with the opinions and preferences of the parents .
The laws governing consent and confidentiality in adolescent health care vary from country to country; within the United States, they vary from state to state. The specific provisions of consent laws and confidentiality laws also vary and are not identical to each other. The information in this topic focuses on consent in adolescent health care in the United States.
Clinicians who treat adolescents must be aware of the federal and state laws related to adolescent consent and confidentiality. The circumstances in which adolescents may consent for their own care and in which confidentiality is protected vary from state to state depending upon the adolescent's status as a minor or adult, the service involved, and the provider's level of concern regarding harm to the patient or others.
The basic laws governing consent for health care are state laws; clinicians who treat adolescents need to be aware of the laws in their state. Confidentiality provisions are found in both state and federal law. Clinicians who treat adolescents also must be aware of the guidelines governing federal and state funding sources for particular services, particularly when funding source guidelines contain specific requirements related to confidentiality. They should also be familiar with the consent and confidentiality policies of the facility in which they practice, and they must be aware of potential ways in which confidentiality can be compromised (eg, record keeping, billing statements, insurance claims).
After a review of important aspects of minor status, and the definitions of consent, notification, and judicial bypass, this topic will discuss how minor status affects the ability to consent to medical services and the different types of medical services for which minors are able to give their own consent. Confidentiality, a closely related but separate concept, is discussed elsewhere. (See "Confidentiality in adolescent health care".)
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- MINOR STATUS
- Emancipated minor
- Medical emancipation
- Mature minor
- Who gives consent?
- - Minors
- - Emancipated minors
- - “Medically emancipated” minors
- - Mature minors
- Consent versus notification
- CONSENT FOR SPECIFIC SERVICES
- Emergency care
- Contraceptive services
- Sexually transmitted infections
- - Cervical dysplasia
- Prenatal care
- - Judicial bypass
- Drug or alcohol care
- - Parent-requested drug testing
- Mental health services
- Minors as parents
- REFUSAL TO CONSENT
- LIABILITY FOR PAYMENT