Adolescent Confidentiality and Privacy
The Bright Futures Guidelines, 4th Edition, recommend that adolescents start having confidential, one-on-one time with their pediatric health care professional during early adolescence. This information is excerpted from the Adolescent Health Consortium’s Investing in Adolescent and Young Adult Health report (as part of the AAP Adolescent Health Care Campaign Toolkit, which includes strategies to create an adolescent supportive practice and professional and family-focused resources).
- Confidentiality refers to the idea that discussions between an adolescent or young adult patient and their pediatric healthcare professionals are kept private and not shared with the patient’s parents or other third parties without the permission of the patient. (See State Laws and Exceptions to Confidentiality below.)
- The benefits of adolescent confidential health care include fostering health, encouraging independence, building therapeutic relationships, and discussing critical and sensitive health topics (eg, sexual/reproductive health, substance use, mental/emotional well-being, risk-taking behaviors). Adolescent patients are more likely to disclose health information if they trust their pediatric healthcare professionals. Trust-based relationships can lead to better interactions and higher-quality health visits.
- Pediatric healthcare professionals should recognize parents as a critical partner in fostering adolescent health and provide appropriate guidance to navigate health questions and concerns.
- In early adolescence, pediatric healthcare professionals should introduce their privacy policy and confidentiality practices to adolescents and their families, including situations in which confidentiality may be broken (eg, threat to self or others, abuse/neglect, reportable diagnosis [only to the health department]). Inform families that health supervision visits for adolescents will include one-on-one time to speak with the adolescent during the health supervision visit. Confidential topics include discussions about sexual/reproductive health, substance use, mental/emotional well-being, risk-taking behavior, and anything else of concern to the specific adolescent.
State Laws
Pediatric healthcare professionals should adhere to state’s laws concerning confidentiality and consent, including ways in which confidentiality can be compromised (eg, record keeping, billing statements, insurance). Pediatric healthcare professionals and medical institutions need to establish systems to protect adolescent confidentiality in the medical record and limit sharing of confidential information.
Exceptions to Confidentiality
Pediatric health care professionals should adhere to exceptions to confidentiality, eg, imminent danger/abuse, self-harm, or reportable sexually transmitted infection diagnosis (to the health department). The University of Michigan’s Adolescent Health Initiative offers training videos around confidentiality laws.
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