Confidentiality minor-children

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  • 1. Confidentiality Issues When MinorChildren Disclose

2. What is Confidentiality? Right of an individual to keep hisor her medical informationprivate. Fundamental to any therapeuticrelationship. Every client expects it. Health Insurance Portability andAccountability Act of 1996 andCalifornias Confidentiality ofMedical Information Act. Patients should provide writtenconsent to release any medicalinformation. 3. When Can you BreakConfidentiality? When physicians release informationabout the patient without the consent ofthe patient. When physicians discuss about thepatients condition to third party. When health insurance employeesdistribute or access unauthorized medicalrecords. Medical Laboratories and public healthemployees who distribute medical records. This wide involvement of different partieserodes privacy (Landrum, 2003). 4. How does Confidentiality DifferWith Minors? Minors are unable to give informed voluntary consent(Gustafson & McNamara, 1987). Some adolescents will enter a therapeutic treatment onlywhen confidentiality is guaranteed. Responsibility of healthcare professional to identify the bestinterest of minors. Juvenile crime and substance abuse among minors hascreated thes need to share information to law enforcementauthorities (Isaacs and Stone, 2001). There is little guidance from laws to protect minors rightsand provide information to legitimate third parties. 5. Minors Confidentiality Laws Court allows minors who are aged 15 and above to give consentbecause of the higher mental maturity. Minors can pursue treatment without parental knowledge. This legalright to pursue treatment is given in cases where parentalintervention may jeopardize the needed treatment. Parents should sign authorization for minors or minors should signwhen they consent to healthcare voluntarily or by law. California Civil, Penal and Family Code lay down rules regardingwhat information should be shared with others and thecircumstances in which it can be shared. Healthcare providers who violate Californias CIMA can be heldcriminally and civilly liable. 6. Different kinds of Minor Consent Literature identifies four kinds of consent (Isaac and Stone,2001). Complete Confidentiality No disclosure to parents orothers. Limited Confidentiality Minors waive the right to knowwhat will be disclosed. Informed Forced Consent Minors are given advance noticethat information will be disclosed to parents and otherlegitimate agencies. No Confidentiality No guarantees are made aboutconfidentiality. 7. Exceptions to Confidentiality Laws In the case of an emancipated minor, the healthcare provider cannotshare information to the parents without the minors written consent. The healthcare provider can inform the parents with or without theminors consent if the minor is living separate from the parents. Code6922(c). When a minor undergoes abortion, the records should not be sharedwith anyone without the prior consent of the minor. Family planning including contraception, rape, sexually transmitteddiseases and pregnancy should not be disclosed. -Code 123110(a) and123115(a)(1). Sharing is permitted without minors consent when certain diseaseshave to be reported to authority, sharing for treatment or paymentpurposes and reporting child abuse. California Civil Code 56.13 8. Conclusion Confidentiality is essential . Laws are different for minors. Californias CIMA and theFederal HIPAA protect privacy. There are certain exceptionsto sharing information basedon the situation involved. In all other cases, writtenpermission is required. Healthcare provider can facelegal action for violations. 9. ReferencesLandrum, S. E.(2003)."Patients rights andresponsibilities." Journal ofthe Arkansas MedicalSociety Vol 99. p 222223.Gustafson, Kathryn;McNamara, Regis. (1987).Confidentiality with MinorClients: Issues andGuidelines for Therapists.Professional Psychology,Research and Practice. Vol18(5). p 503-508. 10. ReferencesIsaac, Madelyn; Stone, Carolyn.(2001). Confidentiality withMinors: Mental HealthCounselors Attitudes towardbreaching or preservingconfidentiality. Journal ofMental Health Counseling.Vol 23(4). p 1-342.Goodman, Rebeca. (October2006). Minor Consent,Confidentiality and ChildAbuse Reporting inCalifornia. National Centerfor Youth Law. Retrievedfrom:

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