how can a medical professional report a minor and still keep the patient trust

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.

Full Answer

How do you deal with a minor patient seeking medical treatment?

Encourage the minor patient to involve his or her parents and offer to facilitate conversation between the patient and the parents. Inform the patient that despite the physician’s respect for confidentiality the minor patient’s parents/guardians may learn about the request for treatment or testing through other means (e.g., insurance statements).

How do you inform a minor patient of a medical procedure?

Inform the patient that despite the physician’s respect for confidentiality the minor patient’s parents/guardians may learn about the request for treatment or testing through other means (e.g., insurance statements).

Can a parent get medical information from a minor?

Additionally, information recorded in a minor's record that is protected by statute should only be released on consent of the minor. At times, a parent may choose to give another person the power to consent to medical and/or emergency treatment for their child on their behalf.

What should a medical practitioner know about minors’ confidentiality rights?

Practitioners who treat minors should begin by familiarizing themselves with state laws regarding minors’ confidentiality rights. Knowing applicable state laws may suddenly become vital, for example, if a parent demands to see information about his or her child in the practitioner’s records.

What is the most appropriate way to establish trust with a patient?

7 Ways To Build Rapport With PatientsMaintain Eye Contact. Maintaining eye contact communicates care and compassion. ... Show Empathy. Empathy is the ability to understand the patient's situation, perspective, and feelings. ... Open Communication. ... Make it Personal. ... Active Listening. ... Practice Mirroring. ... Keep Your Word.

Should a doctor be able to provide medical care to a minor despite their parents wishes?

Under the law, children are entitled to protection and appropriate medical treatment despite their parents' religious views. Most states require parents to provide a reasonable degree of medical care for their children. Otherwise, they may face legal consequences, regardless of their religious beliefs.

How can patient trust be improved?

5 Tips on How to Increase Patient Retention by Building TrustAsk patients questions to improve their experience. ... Answer your patient's concerns directly. ... Offer additional useful information. ... Communicate effectively by listening actively. ... Build trusted long-term relationships with patients.

Is there an obligation to maintain confidentiality when the patient is an adolescent?

Provision of Health Care to Adolescent Patients Although laws vary by state, all minors have a right to some confidential health care.

Can doctors override parents decisions?

That is, because of the existence of an emergency, treatment is legally permissible, and the court does not need to adjudicate the best interest of the child in approving the physician's decision to override a parental refusal for treatment.

What if parents disagree on medical treatment?

Legal Options When Parents Disagree on Medical Decisions If there is shared decision-making regarding medical issues and both parents cannot come to an agreement, the court will examine the facts both parties put forth and determine what is in the best interest of the child.

How doctors can build trust with patients?

How Doctors Can Build Trust With Their PatientsEYE CONTACT: It is an important way of building an instant bond. ... LIGHT TOUCH: If circumstances are appropriate, “touch definitely conveys caring,” Park says.More items...•

How can a doctor build confidence or trust in the patient?

Getting to know a patient and what may be their barriers to medical care can help physicians build trust. Before starting an exam, it can be helpful to talk to patients about their stress and help them address those factors if the patient expresses that their stress is high.

How do you rebuild trust in healthcare?

Through community partnerships with safe, trusted fixtures in a community, health systems can establish more trust through a relatable forum and provide culturally appropriate public health messaging, which often results in better health outcomes.

Do minors have the right to confidentiality?

The law allows the minor the corresponding right of confidentiality and the right to authorize disclosure of treatment information. As a result, the therapist must obtain a signed Authorization Form from the minor patient to release their confidential information, or any part of the treatment record, to parents.

When counseling minors the legal right to confidentiality belongs to?

For minors, however, the right to privacy in therapy is limited. Legally speaking, people under the age of 18 do not typically have a right to confidentiality in therapy. However, some therapists ask parents to agree to the therapist's confidentiality rules before they will treat the client.

How do you maintain confidentiality in healthcare?

Record and use only the information necessary. Access only the information you need. Keep information and records physically and electronically secure and confidential (for example leave your desk tidy, take care not to be overheard when discussing cases and never discuss cases in public places.

What happens if a parent refuses to consent to a treatment for their child?

But if the parents refuse to consent to a treatment for their child patient that the physician thinks is in the child’s best interests, the question arises of whether the physician should take a more paternalistic attitude toward the situation and ask the court to force to allow the treatment to proceed.

What is the capacity to give consent to a diagnosis?

To be able to give consent such patients must have what has been called “decision-making capacity” or “decisional capacity.”.

What is the preferred relationship between a physician and a patient?

A traditional model of the preferred relationship between physician and patient was that of “paternalism.” In that model, the physician acted in whatever way he or she felt would most benefit the patient, even though sometimes this seemed to fail to respect the patient’s own right, freedom, or autonomy to know details of the diagnosis, all the treatment options, and make healthcare decisions for himself or herself.

What is an emancipated minor?

Emancipated minors are under eighteen but recognized as adults. The basic idea for such a category is that a teenager who is living apart from parents, independently, managing their own finances, and maybe even married, is in effect acting as an adult already.

What is considered a mature minor?

Some states and countries recognize a legal category of “mature minor,” a person under eighteen, and depending on jurisdiction sometimes as young as twelve, who can for some purposes be treated as an adult.

Can a child be incapacitated by mental illness?

The patient must not be incapacitated by mental impairment , alcohol, drugs, or by the disease itself. Young children cannot understand the nature of most medical procedures or assess the expected benefits in light of the possible risks. Spelling out complicated procedures in detail will confuse and may scare them.

Do parents have a right to know what is going on in their children's lives?

So naturally if a young child needs healthcare, the provider will tell the parents the diagnosis of the child’s problem . Young children are generally not thought to have any moral or legal right to keep such information private from their parents.

What is the definition of emancipation?

Emancipation occurs when an individual reaches the age of majority, legally weds, enlists in the military or has a child. Another type of emancipation is express emancipation. Express emancipation occurs when a parent and child agree that the child is able to live alone and support him/herself. Doctor-patient confidentiality exists ...

What are the rules for doctor-patient confidentiality?

The law states that when a minor is mature and can be examined without a parent present, he/she should be encouraged to take part in the decision making process.

When does emancipation occur?

Emancipation occurs when an individual reaches the age of majority, legally weds , enlists in the military or has a child.

What is considered a minor?

A minor is considered an adult at the age of majority or at emancipation. If you have not reached the age of majority or been emancipated, you are a minor. In most states, the age of majority is eighteen. Some states set the age of majority at nineteen. Regardless of age, some states consider the age of majority to occur ...

Should parents of immature minors be consulted?

The parent of an immature minor should be consulted so that an informed health care decision can be made. Another exception is when the welfare of the minor is at stake. The doctor can also breach confidentiality when a situation arises that mimics a situation that would allow a breach in confidentiality for adults, such as, ...

Can a doctor convince a minor to involve his parent?

The doctor may try to convince the minor to involve the parent but cannot insist unless the minor is immature or in serious harm. In addition, there can be a breach of confidentiality based on the same reasons for a breach with an adult, such as, in cases of suspected abuse..

Can a doctor force parental involvement?

Depending on age and circumstances, a doctor can and perhaps should encourage parental involvement. However, the doctor should not force parental involvement. There are exceptions to this rule. One exception is when a minor is immature.

What is the American Academy of Pediatrics advice for parents?

Instead of seeking informed consent, then, the American Academy of Pediatrics advises physicians to obtain “parental permission” and, when developmentally appropriate, assent (willingness to undergo the proposed treatment) from the young patient.

What is the code of ethics for physicians?

Consistent with this shift in philosophical priorities, the American Medical Association’s Code of Medical Ethics now states that “it is a fundamental ethical requirement that a physician should at all times deal honestly and openly with patients.

Why was Jill in the hospital?

But over the past several weeks, Jill was in the hospital more often—the combine d result of frequent infection and the toxic agents needed to treat her leukemia.

What did Jill's parents think of her after her schoolmate died?

Not long after Jill seemed to be recovering from the most intense effects of her schoolmate’s death, she was diagnosed with leukemia. Her parents feared that telling her she had leukemia would compromise her emotional health and well-being.

What is the sacred duty of a physician?

The American Medical Association itself endorsed the practice in its 1847 Code of Medical Ethics, stating that a physician has “a sacred duty…to avoid all things which have a tendency to discourage the patient and depress his spirits ” [20].

What is informed consent?

The goal is to elucidate the patient’s values and preferences, given the decision and surrounding circumstances [8-11, 13]. Even for most adults lacking capacity, a surrogate strives to make decisions based on the adult patient’s previously expressed preferences in accordance with the standard of substituted judgment [16].

Is informed consent legal in pediatrics?

In pediatrics, informed consent is at best an imperfect fit [8-10, 15]. Generally, a pediatric patient is not and never has been legally competent to make medical decisions. Until the child reaches 18, legal authority is vested in the patient’s parents to determine what is in their child’s best interest.

What are some examples of a doctor breeching the teen's confidentiality?

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.

What is the duty of a doctor to inform parents of a teen's behavior?

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.

When do you have to notify parents of a minor?

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.

How can a child be afforded a degree of doctor-patient confidentiality?

The only way this can be achieved is through private consultations and examinations.

Do teens have a right to confidentiality?

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.

Do you have to notify parents of abortion?

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.

Do teens need to tell their parents about their mental health issues?

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.

What to do if a minor is in an emergency department?

(If a minor comes to an Emergency Department for care, assure no payment questions are asked until the minor has received a Medical Screening Exam (MSE) to avoid an EMTALA violation.)

What age can a minor consent to a mental health treatment?

At age 14 and older for treatment of STDs. At age 12 and older for drug and alcohol abuse treatment. A minor's ability to consent to other services, including contraceptive services or mental health services is dependent upon the provider's determination that the minor is competent to make an informed consent.

How long does it take to report a sexual assault to the Department of Children and Families?

33VSA 4911 Health care providers are required to report such incidents to the Department of Children and Families within 24 hours.

How old do you have to be to give consent to family planning?

A minor may consent to family planning services. Is twelve years of age or older who is found to be drug dependent by two or more physicians may give consent to treatment related to this diagnosis. Chapter 112- Section 12E. Is sixteen years of age or older may commit themselves to a mental health facility.

Why is consent important for minors?

The laws encourage young people to seek the health care services they need and allow them to speak candidly and confidentially with their health care providers.

How old do you have to be to commit to mental health?

Is sixteen years of age or older may commit themselves to a mental health facility. Children who believe they have contracted a dangerous, contagious disease, diseases dangerous to public health, and STDs. Abortion requires the consent of the patient (minor) as well as both parents. Chapter 112- Section 12S.

What powers does a parent have in Maine?

In Maine, there is a law that provides for the delegation of powers by a parent or guardian in Title 18-C Section 5-126: "A parent or guardian of a minor or incapacitated person, by a properly executed power of attorney, may delegate to another person, for a period not exceeding 12 months, any of that parent's or guardian's powers regarding care, custody, or property of the minor child or ward , except the power to consent to marriage or adoption of a minor ward . A delegation by court appointed guardian shall become effective only when the power of attorney is filed with the court." This statute is designed to facilitate medical care and treatment in cases where the parent or guardian is unavailable.

What is the threshold issue surrounding minors' privacy rights?

The threshold issue surrounding minors’ privacy rights is who gets to make decisions about the privacy and disclosure of the minor’s mental health information. When you treat an adult, your legal and ethical obligations typically are to that client. Accordingly, your client is the person with whom you deal in addressing issues ...

What are minors' rights?

Variability in State Law. State laws on minors’ privacy rights vary considerably. In some states, for example, a child of a certain age, typically in his or her early teens, has a right to object to his or her parent’s request to access the minor’s record. In other states, the parents are allowed to access the child’s mental health records, ...

What is the privacy rule?

Instead, in the area of minors’ rights to confidentiality, the Privacy Rule determines who controls the child’s privacy rights by looking to certain issues under state law. One of these issues is whether the law allows a minor to consent to treatment.

When parents are divorced, should they be vigilant?

When Parents Are Divorced or Separated. Practitioners should be particularly vigilant when treating a minor whose parents are either divorced or separated . Different custody arrangements may require that one parent or both consent to treatment.

Who decides how to deal with privacy issues?

However, when your client is a minor, you often must let the minor’s parent or legal guardian decide how to deal with privacy issues.

Can parents access mental health records?

In other states, the parents are allowed to access the child’s mental health records, but there may be limitations — for example, if a court denies access, or the psychologist determines that granting access is detrimental to the minor’s psychological well being.

Does HIPAA have a privacy rule?

Unlike with other parts of the HIPAA Privacy Rule, this is not simply a matter of determining whether the Privacy Rule or state law is more stringent — that is, more protective of privacy — and therefore takes precedence. Instead, in the area of minors’ rights to confidentiality, the Privacy Rule determines who controls ...

Who is the personal representative of a minor child?

With respect to general treatment situations, a parent, guardian, or other person acting in loco parentis usually is the personal representative of the minor child, and a health care provider is permitted to share patient information with a patient’s personal representative under the Privacy Rule.

What is the Privacy Rule?

In doing so, the Privacy Rule permits a covered entity to disclose to a parent, or provide the parent with access to, a minor child’s protected health information when and to the extent it is permitted or required by State or other laws (including relevant case law).

Is a parent considered a minor's personal representative?

However, section 164.502 (g) of the Privacy Rule contains several important exceptions to this general rule. A parent is not treated as a minor child’s personal representative when: (1) State or other law does not require the consent of a parent or other person before a minor can obtain a particular health care service, ...

How does a minor trust work?

Trusts for minors are usually set up by parents or relatives who want to leave property to a young person, but also want to name a trusted adult to care for the property until the child is old enough to be financially responsible. This kind of trust can be set up within a will or living trust.

What happens to a minor's trust when the maker of the will dies?

When the maker of the will or trust dies, the minor’s trust is created according to the terms of the document. The trustee receives the property and cares for it until the young person reaches the age stated by the trust. When that time comes, the trustee will transfer property from the minor’s trust to the beneficiary outright—including any income ...

What is a minor's trust?

Use a minor's trust to make sure that a trusted adult will manage a young person's inheritance. A “minor’s trust” is a trust that leaves property to a young person, but in the care of a trustee, until the young person reaches a designated age—often age 18, 21, or 25.

When do you have to end a 2053c trust?

But to get the tax benefit, a 2053 (c) trust must end—and the young person must receive all trust property—at age 21. Trusts for minors are usually set up by parents or relatives who want to leave property to a young person, but also want to name a trusted adult to care for the property until the child is old enough to be financially responsible.

Can a gift be distributed until a certain age?

Normally, this exemption only extends to gifts that are actually received by the recipient, so a gift that is not distributed until a person reaches a certain age wouldn’t qualify for the exemption. However the IRS allows an exception (though IRS Code §2053 (c)) that allows the $14,000 exemption to apply to gifts to trusts for minors if ...

Can a minor be a beneficiary of a trust?

The minor is the only beneficiary of the trust. However, the trust can state that if the child dies before turning 21, unless the child gave away the trust assets in the will, then the trust assets can be paid to or held in trust for others, such as the child's brothers and sisters. Any income the trust makes and the original assets transferred ...

Who do you leave property to when you die?

In the document, you leave the property to the young person, but you also include a provision that says if that person is still a minor when you die, that you leave the property to a trustee who must care for the property until the child reaches an age you state.

Introduction

Young Children

Adolescents

Mature Minors and Emancipated Minors

Conflict Between Parent and Provider Over Treatment of Minors

• A traditional model of the preferred relationship between physician and patient was that of “paternalism.” In that model, the physician acted in whatever way he or she felt would most benefit the patient, even though sometimes this seemed to fail to respect the patient’s own right, freedom, or autonomy to know details of the diagnosis, all the trea...

See more on medicine.missouri.edu

Case

Commentary

Therapeutic Privilege and A Minor’S Right to Know

Clinical Realities of Nondisclosure: Problems and Unintended Harms

• Yet, some parents and even physicians are tempted to withhold a life-threatening diagnosis from pediatric patients [26-28]. Not disclosing a diagnosis, though, is fraught with its own obstacles and harms [1, 5, 10]. More often than not, the child is aware of the hushed whispers and discussions among grown-ups and can ascertain that a secret exists ...

See more on journalofethics.ama-assn.org

Conclusion