Doctor - Teen Patient Confidentiality: What You Should Know

The limits of doctor patient confidentiality with teens.

From the time babies are born, new parents are present in the room while children are seen by pediatricians. As children reach their teenage years, either the child or the doctor will ask the parents to remain in the waiting room during the examination. For many parents, this transition can feel unsettling.

There is a good reason for this separation, however. Once children have reached the teen years, they are old enough to be afforded a degree of doctor-patient confidentiality. The only way this can be achieved is through private consultations and examinations.


What Pediatricians Can't Tell Parents

Laws regarding how much information can be kept from parents differ from state-to-state, and different doctor’s offices may have different policies regarding this matter. For the most part, however, there are several things that pediatricians will keep confidential, and with good reason.

  • Sexual activity: Many teens are sexually active but may not feel comfortable letting their parents know this fact. Teens that are engaging in sexual activity may be at risk for sexually transmitted diseases or other health risks. When teens can speak honestly with their doctors about this subject, they can receive STD testing and medical advice and can discuss birth control options. Remember, doctors are not in a position to pass moral judgment; they are merely there to ensure that your child has the best preventive care possible. The pediatrician is likely to council your child to have a frank conversation with you about sexual matters, but cannot require it.
  • Drug and alcohol use: No parent wants to hear that their child is drinking alcohol or using drugs, and few teens would be willing to admit it. However, it is sometimes crucial that pediatricians are aware of any drug or alcohol use. Some medications that may be prescribed can be very dangerous if used in conjunction with certain drugs and there are many health problems that may be caused by substance abuse. It is necessary that your child’s doctor learns all the facts and can properly diagnose and treat your child. The doctor will likely recommend that that your child speak with you about these issues, but may not tell you about them unless serious physical danger could result.
  • Certain mental health issues: Teens who are suffering from depression or anxiety issues may not feel comfortable discussing this with or around their parents. In fact, nearly 45 percent of adolescents state that they would not seek care for issues related to depression if they were required to notify their parents. Doctors need to be able to speak frankly with patients about situations that may be affecting mental health.

When Can Doctors Speak to Parents?

If a teen is exhibiting problems or behavior that can be interpreted as dangerous, it is the doctor’s duty to inform the parents. The decision about whether not to inform parents is usually left up to the doctor, though some states have specific laws or guidelines that dictate when disclosure is required. If the doctor suspects that the problems originate in the home and that the child is in danger, the authorities may be notified.

Some examples of instances where the doctor may breech the teen’s confidentiality include:

  • HIV and AIDS: In most cases, testing for the presence of HIV antibodies is done confidentially. However, if test results are positive for this disease, the decision to notify parents can be a tricky one. Some states require that physicians notify parents only if the teen is under the age of 16, others may require disclosure for any minor. Still others mandate that the doctor maintain the teen’s confidentiality. In all cases, your pediatrician is likely to encourage your child to speak with you about this matter.
  • Contraception: In 1977, the United States Supreme Court decreed that teens have a right to confidentiality when it comes to contraception. However, fewer than half of the states in the U.S. uphold this right. Some states require that parents are notified about contraceptive measures administered by doctors while others enable teens to receive this treatment or medication confidentially. You will need to speak with your child’s doctor to learn the policies practiced in their particular offices.
  • Abortion: Again, this matter is dictated by state law. Many states require parental notification if a minor is seeking an abortion, but the Supreme Court has ordered that, if such a law exists, there must be a way that this notification can be bypassed if a teen can show that abortion is in her best interest and that notifying parents could be dangerous.
  • Severe mental health issues: If teens exhibit signs of severe emotional and mental health problems, are at risk for suicide or can endanger those around them, the treating physicians have a duty to notify parents. If the doctor suspects that these issues may stem from major problems within the home, authorities may be called on to investigate the child’s living conditions.

Learn More By Speaking with Your Child’s Doctor

Because confidentiality agreements can vary from state to state and office to office, it is important that you request a copy of the privacy policies in the doctor’s office. Your teen should also be aware of these policies. A teen who understands that disclosing important, but personal, information to the doctor will be kept confidential is most likely to receive appropriate treatment and preventive care.