A 15 year old girl comes requesting the oral contraceptive pill (OCP). She is sexually active and her sexual partner is also 15 years old. She does not want her parents to know about her sexual relationship with this boy. What is the SINGLE most appropriate action?
A. Breach confidentiality and inform her parents
B. Advise her about safe sex and prescribe OCP
C. Inform her that it is illegal for her to have a sexual relationship with a 15 year old boy
D. Contact the police and local safeguarding officer
E. Inform her that it is illegal to prescribe the pill for her
This question is testing your knowledge on the Fraser Criteria.
For the under-16s
GMC guidance states that the duty of confidentiality is the same for children and young people as it is for adults.
Confidentiality may only be breached in order to protect the adolescent or others from serious harm - for example, where issues such as child abuse and child protection are involved, or where required by law. In this situation the adolescent should be informed of the disclosure and the reasons for it.
Guidance also states that ‘any competent young person, regardless of age, can independently seek medical advice and give valid consent to treatment’. Note that the ability to consent changes if you are under 13. By law children under 13 are considered unable to consent.
Contraceptive advice or treatment can be provided to a competent young person aged under 16 years, without parental consent or knowledge, using the Fraser criteria. A health professional needs to be satisfied that: - The young person could understand the advice and have sufficient maturity to understand what was involved in terms of the moral, social and emotional implications. - They could neither persuade the young person to inform the parents, nor to allow the health professional to inform them, that contraceptive advice was being sought. - The young person would be very likely to begin or to continue having sexual intercourse with or without contraceptive treatment. - Without contraceptive advice or treatment, the young person’s physical or mental health or both would be likely to suffer. - The young person’s best interests required the health professional to give contraceptive advice or treatment or both without parental consent.