Confidential Health Services for Adolescents

Yank D. Coble Jr, MD; E. Harvey Estes Jr, MD; C. Alvin Head, MD; Mitchell S. Karlan, MD; William R. Kennedy, MD; Patricia Joy Numann, MD; William C. Scott, MD; W. Douglas Skelton, MD; Richard M. Steinhilber, MD; Jack P. Strong, MD; Christine C. Toevs; Henry N. Wagner Jr, MD; Jerod M. Loeb, PhD; Robert C. Rinaldi, PhD; Janet E. Gans, PhD
JAMA. 1993;269(11):1420-1424. doi:10.1001/jama.1993.03500110088042.
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DURING the past 20 years rates of suicide,1 illicit drug use,2 sexually transmissible diseases (STDs),3 and births to single mothers4 have increased dramatically among adolescents. The changing nature of adolescent morbidity and mortality makes it critical that they receive medical care on a timely basis, and that barriers to care are removed.5 One such barrier for many adolescents is their concern about whether sensitive information shared in private with their physician will remain confidential.

See also p 1404.

This report reviews adolescents' need for confidential health services and support by physicians and organized medicine for confidential care. Examined are two major barriers to confidential medical care: the prerogative to provide informed consent for medical treatment and payment for health services. The report describes how physicians can balance parental involvement and adolescents' needs for privacy in health care decisions and strategies to allay parental concerns and


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