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Practices must be able to protect the confidentiality of adolescent patients’ sensitive condition treatment information in patient portals. Consider the following case.

Many states allow third parties (e.g., relatives and nannies) to consent to a minor’s medical treatment, as long as the parent’s/guardian’s authorization is already in place. Clinicians are sometimes tempted to bend the minor consent rules when the adolescent is older or when the patient comes in with a relative who appears to be a caretaker, even though that caretaker does not have legal standing to consent to the adolescent’s medical treatment. Consider the conflicting interests of the parties in the following case.

Not all adolescent consent issues involve sensitive treatment scenarios. As adolescent patients become drivers, they are more likely to present for treatment without a parent. Although a patient may seem mature enough to consent for general treatment, a parent’s consent is still required. Consider the following case.

In most states, adolescent patients have legal capacity to consent to substance abuse treatment. However, in a small minority of states, parents have a right to seek substance abuse treatment for their child, even when the child objects. Additionally, some states allow providers to notify the parents about treatment to which a minor has consented (or disclose information about the treatment), even without the minor’s consent to such disclosure.¹ Consequently, consent for diagnosis and treatment associated with substance abuse should be handled carefully. Consider the following case.

Adolescent privacy laws vary in significant ways from state to state and may conflict with federal laws.¹ In addition to minor consent laws, clinicians treating adolescent patients should be familiar with state and federal medical information privacy laws as they relate to adolescent healthcare and should develop clear policies and protocols for appropriately protecting this confidential information.