TODAY TOPIC: CONFIDENTIALITY RIGHT in CHILDREN/ ADJUST AS YOUR STATE- PESCI IS SPECIFIC
Unless someone’s going to be seriously harmed or killed, a doctor or other health professional has to keep what patient say private, EVEN FROM PARENTS/GUARDIAN. The age that patient has automatic confidentiality rights is:
• Fourteen or older in the NT
• Sixteen or older in NSW
• Sixteen or older in SA if two doctors sign off on a specific course of treatment
• Eighteen and older everywhere else in Australia
Even if patient is below the age of gaining automatic confidentiality rights in your state, most things patient say to a doctor, including things about sex, drug use and other difficult stuff will remain private. If patient is seventeen or eighteen, it’s up to doctors whether they report it. Exception is thing that happen in the past and may affect patient life currently, the doctor has to report
Things doctors need to consider when dealing with patients under the previous age limits:
• Patient age and maturity
• How independent patient is – e.g. if he/she lives at home, support him/herself etc
• How serious the treatment is
• Whether patient understands why he/she needs treatment, what it involves and side effects
A doctor does have to break confidentiality if they think patient is at risk of harm or in danger. If patient tell doctor that he/she is involved in a serious crime (like murder, drug-dealing, sexual assault or assault), they might have to report it. Again, ask.
The following urls are very useful:
http://au.reachout.com/confidentiality
http://au.reachout.com/all-about-age-and-confidentiality
THE THREE ANGLES OF CONFIDENTIALITY
A) LAW: below 18 years, parents should give consent for treatment and they have the right to know the treatment. Exceptions applied by doctor point of view (child will be at risk)
B) CLINICAL PRACTICE: Good clinical treatment may require what the law generally refuses, that is, a zone of privacy.
C) ETHICS: Can our Ethics Code ease the apparent tension between law and clinical practice?
Please have a look on the following url
http://www.apa.org/monitor/mar02/confidentiality.aspx
In summary, in most cases, doctors will not be trapped in this dilemma. However, in case where there is a conflicts between ethics, law, clinical practice and when the minor is at risk, the best strategy is to get your colleague and supervisors involved
I wish this help to address your concern regarding minor
FOR MORE TRAPS, PLEASE JOIN THE UPCOMING LAST PESCI RECALL COURSE FOR ACRRM 2018- THE MOST RECENT 50 CASES APPEARED IN ACRRM
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Good luck,
Dr Mathew