This assignment is to respond to those 2 discussion posts posted below. Each answer should be a minimum of 150 words APA format. All replies must be constructive and use literature where possible by extending, refuting/correcting, or adding additional nuance to my peers with at least 2 sources each. Sources cannot be older than 5 years and must be from the course book: McCance Burns, C. E., Dunn, M. A., Brady, A. M., Starr, B. N., Blosser, G. C., & Garzon, L. D. (2017).
Question 1 (HG)
Parents may be concerns on whether their child is sexually active or not. Despite what parents may like to believe, their children will become sexual people. Primary care providers play a very important role in educating parents to anticipate, understand and direct their children through sexual growth. The visit to primary care offers parents an opportunity to ask questions and ask the child’s provider for advice (Burns, Dunn, Brady, Starr, Blosser & Garzon, 2016, p. 285). Although it is natural for parents to concern about their child’s sexual activities or history, there are laws and rights regarding patient confidentiality that needs to be employed. As a health care provider, when a parent approach and want to know if their child is sexually active, the parent may be reassured that it is understandable to have concerns and questions. After reassuring the parent the provider may have to speak to the parent in private and find out if there is a reason for their concerns. If there are no concerns, the provider should remind the parent that minor patients have the right to privacy and confidentiality unless there is a concern that may risk the patient’s health or life, the patient’s health information have to be kept confidential.
Confidentiality protection is essential to providing quality health care to adolescents. High-risk activities such as unsafe sex are considered to be one of the main causes of morbidity and mortality in this age group (Santos, 2012). Many teenagers would not be honest with their physicians if they felt their health information had been revealed to their parents (Morin, 2020).Clinicians who take care of minors should familiarize themselves with state and local laws that affect the rights of minors to agree to health services, as well as federal and state laws that affect confidentiality in the provision of their health care services. Physicians should address confidentiality with the adolescent and the parent or guardian, if present, at the first visit to the clinic (Santos, 2012). As a practitioner, if encounter a similar situation, it is best to reassure the parent that you have the same goal which is the well-being of the adolescent patient. Besides, the provider should use this time to promote communication between the parent and the adolescent patient which may lead to a better relationship. An adolescent is more likely to be open and share more with their parents when is a good relationship between them.
In the state of Florida, minors do have a right to confidentiality health providers may keep this information confidential. However, confidentiality may not be possible if they are any suspected of neglect, child, and sexual abuse. For instance, examination, and treatment of a minor for sexually transmitted diseases is confidential except reporting it to the health department, and shall not be divulged in any direct or indirect manner, such as sending a bill for services to a parent or guardian (English, Bass, Boyle & Eshragh, 2020).
Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., Blosser, C. G., & Garzon, D. L. (2016). Pediatric primary care(6th ed.). Elsevier.
English, A., Bass, L., Boyle, A. D., & Eshragh, F. (2020, January). State Minor Consent Laws: A Summary[PDF]. Center for Adolescent Health & the Law. https://www.freelists.org/archives/hilac/02-2014/pdftRo8tw89mb.pdfLinks to an external site.
Morin, A. (2020, April 25). Your Teen’s Right to Confidential Reproductive and Sexual Health Care. Very Well Family. https://www.verywellfamily.com/teens-right-to-confidential-reproductive-health-care-4125234Links to an external site.
Santos, X. M. (2012). Protecting the confidentiality of sexually active adolescents. AMA Journal of Ethics, 14(2), 99–104. https://doi.org/10.1001/virtualmentor.2012.14.2.ccas2-1202Links to an external site.
Question 2 (KR)
Approach to Health Management
As health care providers it is inevitable that at some point of our providing care to our patients we will be forced to deal with unpleasant situations and have to make difficult decisions. The best thing we can do for our patients is base our decisions within the constraints of the laws. It is also important to consider that while dealing with adolescents, trust building is also very important. If adolescents feel like they cannot trust you, they may withhold information that is critical for their care.
There are two primary federal provisions that are in place for the protection of adolescence. The first one is the health insurance probability and accountability act (HIPPA), and the second one is the family educational rights and privacy act (FERPA). When it comes to minors HIPPA allows the parents of the minor to have access to their medical records, however there are three exceptions (Pathak & Chou, 2019). The three exceptions are as follows when a minor obtains care at the direction of a court, when a parent agrees for the clinician and the minor to have a confidential relationship, and when consent for care by a parent is not required by law (Pathak & Chou, 2019). FERPA on the other hand allows parents to obtain their minor children’s educational records (Pathak & Chou, 2019). However, if the child is receiving healthcare while at school, those records are subjected to the HIPPA laws (Pathak & Chou, 2019).
Additionally, each state has laws for minors that fall into two categories. The first category is based on the statue of the minor which includes emancipation laws (Pathak & Chou, 2019). These laws allow emancipated minors to make health care decisions without parental involvement (Pathak & Chou, 2019). The second category is based upon the type of care being provided such as sensitive services including family planning, emergency care, mental health care, or drug or alcohol treatment (Pathak & Chou, 2019). There are a few exceptions to these rules. A provider may breech these rules if the patient is determined to pose a danger to themselves or others, suspicion of emotional, physical, or mental abuse, or none consensual sexual activity (Pathak & Chou, 2019).
As a healthcare provider it is imperative that we all educate ourselves on the legal requirements of providing confidential care for adolescence. Failure to do so will only result in a disservice to this population. A study revealed that 25% of high school youth are reluctant to seek healthcare for issues they would like to keep private out of fear that the information will be shared with others (Wadman et al., 2014). Additional studies show that the youth that forego healthcare services are the ones that are at the highest risk and need care the most (Wadman et al., 2014).
Based on the above literature if a 17-year old’s parent would like information on their child, I would rely on the federal laws and state laws as applicable to the specific patient. If the minor meets the requirements for me to share that information with their parents, I will try to do it in a nonjudgmental way and try to encourage a conversation based on honesty between the parent and the child. I would do the same regarding a 14- or 11-year-old. In the state of Florida for example if a physician is to perform a termination of pregnancy or provide emergent care to a minor, then the parent must be notified. This notice is waived only if the minor is married, or if the person entitled to the notice has given permission not to be notified in writing and notarized 30 days prior.
Pathak, P. R., & Chou, A. (2019). Confidential Care for Adolescents in the U.S. Health Care System. Journal of patient-centered research and reviews, 6(1), 46–50. https://doi.org/10.17294/2330-0698.1656Links to an external site.
Wadman, R., Thul, D., Elliott, A. S., Kennedy, A. P., Mitchell, I., & Pinzon, J. L. (2014). Adolescent confidentiality: Understanding and practices of health care providers. Paediatrics & child health, 19(2), e11–e14. https://doi.org/10.1093/pch/19.2.e011
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