All adolescents should have the opportunity to discuss their health care and concerns with the provider privately. Providing a space for confidential conversations and care aids the adolescent’s transition to adulthood and encourages them to begin to take ownership for their health care.
| State by State Considerations |
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| Consent |
- Minor Consent Laws (Present in All States)
- Allow minor adolescents the right to receive sexual health care without parental consent or notification for certain services. These services may include:
- Screening, treatment for STIs
- Pregnancy prevention and care
- Substance abuse treatment
- Many states allow adolescents to consent for mental health care, abortion and emergency care.
- Adolescents also have rights to receive sexual health care independently under the mature minor and emancipated minor.
- Mature Minors
- Adolescent < 18 years who, even if living at home as a dependent, demonstrates the cognitive maturity to give informed consent.
- Emancipated Minors
- Minor becomes emancipated if married, pregnant, has children or obtains declaration from the courts. This varies by state.
- Consent for HIV Testing
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| Confidentiality |
- Define confidentiality with adolescent and parent both present.
Assure both that information from either of them will not be shared without permission Spend time with the patient and family, then ask parent/guardian to step out.
- Confidentiality Definition
- Protection of privileged, private information shared during a health care encounter
and in medical records about the encounter.
- Limits of Confidentiality, Review in Front of All Parties
- Suicidal or homicidal thoughts
- Clinicians must report all wounds inflicted by stabbing or gunshot
- Clinicians are mandated reporters of suspected physical and sexual abuse
- Refer to state laws that specify when sexual activity with a minor is illegal
- Public health laws require reporting of communicable diseases, including some STI’s
- Barriers to Adherence of Confidentiality
- Electronic health records
- Hospital and insurance billing
- Emergency department design
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| MyCHOP Proxy Access |
- Patients 13-18 years of age must assent to allow parents/guardians to access certain categories of medical information, access can be revoked at any time.
- Proxy access will only be granted to parties with parental rights or legal guardianship over the CHOP patient.
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