Confidentiality, sex and teenagers

Confidentiality, sex and teenagers

J. Murty

Leeds Contraception and Sexual Health Services (CASH), South Leeds Primary

Care Trust, Leeds, UK

Introduction: There is opinion by some in society that children are

being encouraged to keep their life secrets from their parents.

Aims and methods: To review the current UK law and ethical debate to

test the question whether this is a recipe for disaster and harm is being done

by doctors keeping the secrets.

Results: The autonomy of the patient is being eroded by the need to

obtain information his/her medical treatment to improve the medical services.

However the need to maintain privacy is important for the individual when

seeking medical advice. The doctor is obliged to disclose information in certain

circumstances but generally will only breach confidentiality if there is likely

to be harm to a third person. Common law cases acknowledge that the sexual

activity of an individual is the most secret part of his or her life. There are

specific laws relating to sexual health that enable the patient to maintain

their right to privacy in the sexual health consultation. Recent cases in

relation to the human immunodeficiency virus are testing the duty of the doctor

to report infection to the sexual partner against the wishes of the patient. The

young person under sixteen has the same rights as the adult in seeking

confidentiality if the young person is competent to understand the advice they

are given. This right also applies to the sexual health consultation even if

technically the young person is acting outside the law. The doctor will not only

try to prevent the spread of infection to the sexual partner, but also has to

weigh up any concerns about sexual abuse. The doctor will generally only

disclose concerns to the appropriate authorities and not to the young person’s

parents. There is not much evidence that providing sexual health advice to those

under sixteen is producing a benefit. The individual may be protected, but in

general there is no overall improvement in the teenage pregnancy rates and there

is an increase in sexually transmitted infection in this age group. Because it

is difficult to get a conviction for under age sex, young people tend to

disregard laws which, in general, are there to protect them as they develop into

adults. Also the rights of privacy for young people may be in conflict with the

rights of parents to have a private and family life. There is no law of privacy

in the United Kingdom to give guidance in this area.

Conclusion: It would appear, therefore, that children are supported to

keep areas of their life secret from their parents. The recipe for disaster is

not for harm to the individual but harm to the family in society.

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