Q&A: Confidentiality a ‘bedrock’ principle of caring for adolescents
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Key takeaways:
- Confidentiality is an essential part of caring for adolescents, ensures that they remain in control.
- Confidentiality protections in medicine are based on federal and state laws.
The AAP offered support for pediatricians in developing policies and practices that align with the confidentiality needs of adolescent patients.
In a new policy statement and technical report published in Pediatrics, the AAP outlined guidance on maintaining confidentiality when caring for adolescents, recommending that clinicians help adolescents develop responsibility for their health, which involves candid and confidential conversations with doctors and being aware of how confidentiality can be impacted by rapidly evolving technologies where information is shared, as well as health care billing and legal requirements.
We spoke with Richard J. Chung, MD, FSAHM, FAAP, one of the authors and a professor of pediatrics at Duke University School of Medicine, regarding the importance of confidentiality in the clinical care of adolescents.
Healio: How does confidentiality impact health care experiences for children?
Chung: Confidentiality is a bedrock of adolescent health care, which ensures that youth can receive care and support for any health need, even if those needs might be sensitive in nature. It means that any information generated from a confidential health care interaction is kept private, unless the teen wants the information disclosed to someone else — or if, in the judgment of the health care provider, there is an immediate safety risk to the teen or someone else. In that situation, the provider would partner with the youth to figure out how to inform a caring adult and get their help.
Ensuring confidentiality is critical to ensuring access to care for youths. Questions or issues frequently arise in adolescence that teens have difficulty engaging their parents or guardians about. Typically, they seek information and help from peers or the internet, or they don’t seek help at all because they don’t feel comfortable asking for it. Confidentiality provisions ensure that they can comfortably access care from a trusted health care professional without fear that their privacy will be compromised.
Importantly, confidentiality doesn’t mean that a parent or guardian cannot be involved if appropriate, but it ensures that the teen remains in control if any disclosures of information are made.
Healio: Do any of the recommendations conflict with state or federal laws?
Chung: Confidentiality protections are actually based on federal and state laws, and clinical practice should never conflict with the laws that govern the place where care is being rendered. All health care providers should be familiar with the laws that apply to their place of practice and should explain those laws, as needed, to teens and their families, so everyone understands how health information is handled.
Healio: Are there some children for whom confidentiality is even more important?
Chung: Confidentiality is important for all adolescents and does not necessarily mean that a specific adolescent is engaged in anything risky or dangerous. Very commonly, confidentiality simply means that they can ask curious questions without fear that their curiosity will be reported to others.
That said, some youths engage in certain health behaviors or experience certain health risks more than others, and those youths may particularly benefit from confidentiality provisions. Confidentiality provisions ensure that a trusted health care professional can discuss potentially risky behaviors or experiences and provide advice and support to mitigate those risks.
References:
Chung RJ, et al. Pediatrics. 2024;doi:10.1542/peds.2024-066326.
Chung RJ, et al. Pediatrics. 2024;doi:10.1542/peds.2024-066327.
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