The assurance of confidentiality in sexual, reproductive, and mental health is an essential element of the therapeutic relationship between adolescents and their health-care providers. Research has shown that adolescents may forgo needed health care for these sensitive concerns if they believe this information will be shared with their parents. To address this issue, laws have been enacted to protect confidentiality when an adolescent seeks care in areas such as sexually transmitted infection testing, contraception, and outpatient mental health services. Confidentiality laws can vary by state and may depend on a practitioner’s assessment of the minor’s ability to make informed decisions regarding his or her health. In some circumstances, however, confidentiality cannot be assured, such as when the adolescent’s safety is at stake. There are also other challenges to preserving confidentiality such as billing for services, the electronic medical record, and patient portals. For this reason, providers should familiarize themselves with the laws regarding adolescent confidentiality in their state and include discussions of confidentiality in each adolescent patient encounter.
KeywordsConfidentiality Informed consent Emancipated or mature minor Explanation of benefits Patient portal
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