Teen Health Supervision

Adolescents visit health care providers for well exams and sports physicals. As teens do not often seek health services, it is important to make the most of these visits. Below, we will address several unique issues related to providing adolescent health care.

Consent and Confidentiality

At what age can a teenager consent for healthcare? At what age is there a guarantee of confidentiality? In the USA, the answers depend on state law and the type of healthcare services.

In most states, parental consent is required for minors; and in most states, minor is defined as less than age 18. With this consent comes the right for the parent to have access to the healthcare information.

However, specific to sexual, mental health and substance use issues, most state laws grant the teenager confidentiality by age 14. This means that if the teen does not want information shared with the parents, health care providers have some discretion. For example, a provider may withhold from parents/guardians information that a teen has experimented with alcohol. If however, the teen had an alcohol use problem, the provider might decide that it was in the teen's best interest for a parent to know.

Sometimes the diagnosis determines whether the care can remain confidential. For example, it is impossible for a provider to know beforehand whether the teenage female's abdominal pain is due to pregnancy, pelvic inflammatory disease, appendicitis or psychiatric distress. As the reasons for the pain become more clear, the limits of confidentiality may change (i.e. if the reason falls into the category of sexual, mental health-related, or substance use).

Limits of confidentiality do not apply in circumstances involving abuse or the intention to harm oneself or another person. For example, a physician must report if a fourteen year old patient is having sex with a thirty year old, whether it is forced or not.

In most states, there are special categories of minors (under 18) who can consent for their own confidential care as if they were adults. These groups might include:

  1. married teens
  2. those on active duty in the military
  3. emancipated youth (those given adult status by a judge)
  4. self-sufficient youth who live without the support of their parents

The bottom line: it is imperative for the healthcare provider to know the laws of the state.