Knowledge Library

Adolescent autonomy and privacy are affected by a tangled web of state and federal laws that clinicians are expected to know and abide by. As a rule, adolescent patients cannot give consent for their own medical treatment before they reach the legal age of majority, which, in most states, is 18. The circumstances in which adolescent patients can consent to their own medical treatment vary by state; however, most states have consent exceptions based on an adolescent’s legal status (e.g., married, emancipated) and select medical conditions (“sensitive medical conditions”).

While the number of people getting vaccinations for their children is relatively stable,¹ some parents and guardians are hesitant about or refuse vaccines, or they want to depart from the recommended schedule. Researchers have identified seven primary reasons for this:^2,3,4

Complicated family dynamics are often on full display in family practice and pediatric offices. Situations involving divorced or separated parents who disagree about their child’s treatment are a typical reason that insured physicians contact the NORCAL Risk Management department for advice. Sometimes the issue is about access to medical records. And, on occasion, a clinical problem is not at the forefront, but the parents are involving their children’s physicians in the family’s difficulties.

The NORCAL Risk Management department often gets calls describing treatment scenarios involving adolescents that do not neatly fit into one of the sensitive treatment categories. These situations often require the clinician to weigh the adolescent’s need for autonomy against the parents’ need to nurture, guide, and protect their child. When the line between what can and cannot be shared with a parent appears legally ambiguous, a physician’s discretion is often the best solution. Consider the following two cases.

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