Introduction
When it comes to medical treatment for minors, the rules around disclosure and consent can be complex. Understanding when and how information is shared is crucial for both parents and young patients.
1. Age of Majority and Consent
In most states, the age of majority is 18. Before this age, parents or legal guardians must typically give consent for medical treatment. This means that healthcare providers need permission from a parent or guardian before treating a minor.
2. Who Can Consent?
It’s not always clear who has the legal authority to consent. Blended families and caregivers can complicate matters. To avoid confusion:
- Require a parent to accompany the minor to the first appointment.
- Ask for proof of guardianship if a legal guardian is involved.
- Have a parent or guardian sign an authorization if a caregiver brings the minor to subsequent appointments.
3. Confidential Care for Adolescents
Confidential care is important for adolescents. It encourages them to seek help and discuss sensitive topics. Many states allow minors to consent to certain types of care without parental permission, such as:
- Sexually transmitted infection (STI) testing and treatment
- Substance misuse treatment
- Pregnancy prevention and care
- Mental health care
- Emergency care
4. Mature Minor Doctrine
Some states recognize the “mature minor” doctrine. This means that an adolescent younger than 18 can give informed consent if they demonstrate the cognitive maturity to understand the treatment and its risks. Factors that influence this include the minor’s developmental maturity, previous experience with illness, and the gravity of the current illness.
5. Privacy and Confidentiality
The privacy rule, based on HIPAA, provides protection against parents’ or guardians’ access to protected health information in certain circumstances. These include:
- Adolescents aged 18 and older
- Emancipated minors
- Minors who can legally consent to services or receive services without parental or guardian consent or notification according to state or other applicable law
- When a parent or guardian assents to an agreement of confidentiality between the minor and healthcare provider
6. When Disclosure Is Required
There are situations when healthcare providers are obligated to inform the minor’s parent or guardian. These include:
- When involving the parent or guardian is necessary to avert life- or health-threatening harm to the patient
- When involving the parent or guardian is necessary to avert serious harm to others
In these cases, the provider should discuss the reasons for the breach of confidentiality with the minor before disclosing the information.
7. Encouraging Parental Involvement
Healthcare providers are encouraged to involve parents in the care of minors whenever possible. They should inform the minor about circumstances in which disclosure to parents is required and offer to facilitate conversations between the patient and parents.
Confidential care for adolescents is important because it encourages access to care and increases discussions about sensitive topics and behaviors.
Conclusion
Understanding the rules around medical disclosure for minors is essential for ensuring that young patients receive the care they need while protecting their privacy and autonomy.