Abstract
Confidentiality is a major issue in adolescent healthcare, and its perceived absence may be the main barrier for an adolescent to seek medical care. Little is known about the right on informative privacy and confidentiality for adolescents in Belgium, although these rights are unambiguously foreseen in the law on patients' rights since 2002. There are no data available regarding the introduction of a private moment with the physician during a consultation, about the nature and the quantity of information made available to parents by the paediatricians regarding the health situation of adolescents and about the existence of procedures with regard to these matters. The purpose of this study is to map out the current interpretation and the attitude of the paediatrician with regard to the right to confidentiality and informative privacy. The answers of 117 Flemish paediatricians to an anonymous questionnaire were analyzed. An unaccompanied medical visit is not frequent in Belgium (only 1%). Only 35.1% of the paediatricians systematically offer the possibility to have a private conversation with an adolescent. Almost 80% of the paediatricians render, as a rule, all information to the parents. Parents are informed about sensible information regarding psychosocial aspects, including data concerning sexual behaviour, in not less than 83.2% of the consultations by adolescents. Only in 2.9% no information is given to the parents. The paediatricians employ only for 13% the procedures regarding confidentiality for minors. This study reveals that Flemish paediatricians have a paternalistic attitude concerning the right on confidentiality and informative privacy, which is not in line with the Belgian legislation. Paediatricians offer only seldom the possibility for a private conversation to the adolescent. The small incidence of unaccompanied medical consultations contributes to this. Proper application of the legal context, the handling of the watertight procedures and the necessary communication in this respect is indispensable for the confidence and will lower the barrier for adolescents to use the healthcare system.
Similar content being viewed by others
References
Adams KE (2004) Mandatory parental notification: the importance of confidential health care for adolescents. J Am Med Womens Assoc 59:87–90
Akinbami LJ, Sandhi H, Cheng TL (2003) Availability of adolescent health services and confidentiality in primary care practices. Pediatrics 111:394–401
Bender SS (1999) Attitude of Icelandic young people toward sexual en reproductive health. Fam Plann Perspect 21:294–301
Berlan ED, Bravender T (2009) Confidentiality, consent, and caring for the adolescent patient. Curr Opin Pediatr 21:450–456
Committee on Adolescence American Academy of Paediatrics (2008) Achieving quality health services for adolescents. Pediatrics 121:1263–1270
Deneyer M, Clybouw C, De Groot E et al. (2010) The surgeon and the Law on Patient's rights to minors. Acta Chir Belg, in press.
Deneyer M, De Groot E, Devroey D et al. (2010) Wet op de patiëntenrechten: in de praktijk niet evident voor minderjarigen. Tijdschr. voor Geneeskunde 66;16:764–9.
Dillman DA (1991) The design and administration of mail surveys. Annu Rev Sociol 17:225–249
Donovan C, Mellanby AR, Jacobson LD et al (1997) Teenagers' views on the general practice consultation and provision contraception. The adolescent working group. Br J Gen Pract 47:715–718
Duncan RE, Drew SE, Hodgson J et al (2009) Is my mum going to hear this? Methodological and ethical challenges in qualitative health research with young people. Soc Sci Med 69:1691–1699
English A, Ford CA (2004) The HIPAA privacy rule and adolescents: legal questions and clinical challenges. Perspect Sex Reprod Health 36:80–86
Farrant B, Watson PD (2004) Health care delivery: perspectives of young people with chronic illness and their parents. J Paediatr Child Health 40:175–179
Fisher M, Golden NH, Bergeson R et al (1996) Update on adolescent health care in paediatric practice. J Adolesc Health 19:394–400
Ford CA, Millstein SG, Halpern-Felsher BL et al (1997) Influence of physican confidentiality assurances on adolescents' willingness to disclose information and seek future health care. A randomized controlled trial. JAMA 278:1029–1034
Garside R, Ayres R, Owen MR et al (2000) General practitioners' attitudes to sexual activity in under-sixteens. J Roy Soc Med 93:563–564
Hutchinson JW, Stafford EM (2005) Changing parental opions about teen privacy through education. Pediatrics 116:966–971
Klostermann BK, Slap GB, Nebrig DM et al (2005) Earning trust and losing it: adolescents' views on rusting physicians. J Fam Pract 54:679–687
Malik R, Oandasan I, Yang M (2002) Health promotion, the family physician and youth: improving the connection. Fam Pract 19:523–528
Oppong-Odiseng AC, Heycock EG (1997) Adolescent health services through their eyes. Arch Dis Child 77:115–119
Perez MD, Pereniguez JE, Osuna E et al (2006) Primary care confidentiality for Spanish adolescents: fact or fiction? J Med Ethics 32:329–334
Reddy DM, Fleming R, Swain C (2002) Effect of mandatory parental notification on adolescent girls' use of sexual health care services. JAMA 288:710–714
Rutishauser C, Esslinger A, Bond L et al (2003) Consultations with adolescents: the gap between their expectations and their experiences. Acta Paediatr 92:1322–1326
Sanci LA, Coffey CM, Veit FC et al (2000) Evaluation of the effectiveness of an educational intervention for general practitioners in adolescent health care: randomised controlled trial. BMJ 320:224–230
Spear S, English A (2007) Protecting confidentiality to safeguard adolescents' health: finding common ground. Contraception 76:73–76
Sultiëns L, Goffin T, Borry P et al (2007) Minors and informed consent: a comparative approach. Eur J Health Law 14:21–24
Urkin J, Bilenko N, Barak N et al (2008) Parental attitude toward unaccompanied clinic visits of adolescents. Int J Adolesc Med Health 20:375–380
Urkin J, Bilenko N, Bar-David Y et al (2008) Who accompanies a child to the office of a physician? Int J Adolesc Med Health 20:513–518
Conflicts of interest
No funding was provided for this study. None of the authors declare any conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Deneyer, M., Devroey, D., De Groot, E. et al. Informative privacy and confidentiality for adolescents: the attitude of the Flemish paediatrician anno 2010. Eur J Pediatr 170, 1159–1163 (2011). https://doi.org/10.1007/s00431-011-1427-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00431-011-1427-4