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Confidentiality, consent, and caring for the adolescent patient

Berlan, Elise D; Bravender, Terrill

doi: 10.1097/MOP.0b013e32832ce009
Adolescent medicine: Edited by Sara F. Forman and Elizabeth R. Woods

Purpose of review This study reviews the healthcare-related rationale for providing confidential care to adolescents, as well as the legal framework for the provision of such care.

Recent findings Physician assurances of confidentiality increase adolescents' willingness to disclose sensitive health information, but these assurances are rarely given. Physicians may not be aware of legal minor consent guidelines or may be concerned about parental reaction to such confidential discussions. Fortunately, many parents and teens understand the importance of confidential healthcare. Adolescent consent and confidentiality laws vary from state to state, but there are federal guidelines and common law concepts that are applicable throughout the United States. The Health Insurance Portability and Accountability Act Privacy Rule also provides guidelines for confidential care to minors. Future challenges for adolescent confidentiality include ease of access to electronic medical records as well as patient (and/or parent)-controlled health records.

Summary Confidentiality for adolescents has important implications for the quality provision of healthcare for this vulnerable population. Physicians and other healthcare providers must be aware of these health implications, as well as federal policies, common law, and their individual state's laws pertaining to this important topic.

Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio, USA

Correspondence to Elise D. Berlan, MD, MPH, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA Tel: +1 614 722 2458; fax: +1 614 355 3583; e-mail:

© 2009 Lippincott Williams & Wilkins, Inc.