A minor patient enters his family doctor's office, appearing
to be very ill and discloses personal information about his health status. He
begs his family doctor, not to tell his parents.
"Please, don't tell my mom and dad!"
What is the family doctor morally, ethically and legally
bound to do? In other words, how does doctor-patient confidentiality apply to
minors?
Globally, medical doctors and other health care professionals, face this kind of a medical dilemma on a regular basis. The discretion and professional judgment of family doctors is extremely important. At the same time, the minor patient often places his family doctor in an awkward and difficult situation.
If the family doctor breaks the confidentiality of a minor patient, the patient may choose to walk away from medical treatment. Where there is a highly contagious disease that could spread rapidly to others if the minor patient does not receive appropriate medical treatment, other people's lives may be at risk. Many minor patients do not realize the serious nature of infectious diseases; nor do they know how quickly diseases can spread to others.
If the family doctor breaks the confidentiality of a minor
patient and goes to the parents of the minor without the permission of the
patient, there may be a total breakdown in the parent-minor patient
relationship. This can be a less than ideal situation.
If the parents have the same family doctor as the minor patient and there is an effective doctor-patient relationship, it can break down when the family doctor discloses the truth to them.
"Why did you tell us about our son's medical condition? Now our relationship with him will be over."
When the family doctor does not disclose the truth to the minor's parents, the family doctor-parent relationship can break down, as well.
"Why did you not tell us about our son's medical condition? We trusted you as our family doctor."
Sometimes the situation can be even more difficult, for
example, when the doctor is not the regular family doctor. There is no
previously established trust relationship.
Each situation is unique and different.
The decision to disclose personal information about minors
has many different aspects to consider.
Care, compassion and concern are an important aspect of any doctor-minor patient relationship, as well as any doctor-parent relationship. Trust, integrity and honesty in all directions are important.
Doctors do not want to become involved in moral, ethical and legal dilemmas with minor patients and their parents, even though it happens at times.
Immediate and appropriate medical treatment and counseling
of the minor patient are important, particularly when this involves the lives
of other people including family members. They should be
aware when there is a serious health problem.
Parents and minor patients often remain in relatively good relationships regardless of a minor patient's health status. That makes it easier for family doctors or others, to bridge the gap between parents and minor patients when there is a difficult medical situation to deal with.
Most parents truly love their children and want what is best for them; minor patients need to know that.
Medical doctors will not generally walk away from difficult situations that involve minor patients; if anything, they will try to resolve the immediate medical issues or concerns in a way that benefits everyone. Be aware that any doctor has the option of recommending that a minor patient find another doctor, if the minor patient insists on non-disclosure to his parents, but that would normally be only as a last resort.
Family doctors are more likely to offer a minor patient a number of different options, regarding the necessary treatment and disclosure of personal medical information. This might involve having the minor patient talk to his or her parents when the family doctor is present or having the patient talk to his or her parents alone, as soon as possible, depending upon the maturity of the minor patient.
A lot depends upon the doctor, the kind of medical scenario that is taking place, the health status of the minor patient, as well as the minor-parent relationship.
There are many medical factors to consider. For example, the
minor patient may need immediate hospitalization or have to be isolated to
protect others from a contagious disease. The parents of a minor patient may
need to sign medical-legal consents for treatment or surgery. Financial issues
like the cost of hospitalization, medication or treatment may enter into the picture.
Community health concerns are also important.
For anyone who is a minor with a serious health problem, it
is always advisable to seek immediate medical treatment from a doctor and to
trust the doctor to use his discretion and professional judgment with regard to
medical treatment.
Yes, doctor-patient confidentiality applies to minors, but
the issue of minor patient confidentiality may become secondary when there is a
life-threatening situation that involves a minor patient or others. Difficult
family situations are generally resolvable over time, particularly when minor patients
trust their family doctors and other doctors, as well as their parents, to do
what is right.
Families sometimes need counseling and medical guidance throughout a medical crisis involving a minor patient in order to restore broken relationships, but these kinds of relationships are repairable.
Healing of family relationships take place where there is
love.
