Confidentiality for Young People

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Introduction

The principles of confidentiality apply equally to all patients regardless of age. 

Young people (including those under 16) are entitled to equal confidentiality, as all other patients. This includes respecting their wishes to withhold information from parents or guardians. The GP involved will determine the competency of a young person seeking treatment and will determine the extent to which confidentiality guidelines apply in each case.

Care must be taken to ensure that this right of confidentiality is not inadvertently breached by following the procedural guidelines in force.
It is generally recognised that parents will accompany children up to 13 years of age. Many will continue to do so past this age but the clinician can check if they are happy to have the parent there if it is regarding something personal.

A child under 16 can come and see a clinician alone. However a clinician must believe that they are capable of understanding the choices of treatment and their consequences. This includes contraceptive advice, but the principles apply to other treatments, including abortion.

The policy of the practice is to support young people in exercising their choice of medical treatment, and to deal with them in a sympathetic and confidential manner. Where a young person presents at the surgery without adult support they may be booked in to see a clinician in the normal way. Where there is some question of the urgency of an appointment the matter should be referred to a nurse in the first instance to triage the request.
 

The Fraser guidelines 

The Fraser guidelines apply to the treatment of contraceptive advice and care.

A clinician should proceed to give advice and treatment where:

  • The Clinician is satisfied that the patient understands the advice given.
  • The Clinician cannot persuade the patient to inform the parents.
  • That the patient is likely to continue having sexual intercourse with or without contraceptive treatment.
  • That unless the patient receives contraceptive advice or treatment their physical or mental health or both are likely to suffer.
  • That the patient’s best interests require the clinician to give them contraceptive advice, treatment or both without the parental consent.

The Gillick Competency

The Gillick Competency in brief is as follows:

  • It is not enough that the patient should understand the nature of the advice which is being given but that the patient should be sufficiently mature to understand it.
  • It is also commonly believed that “the parental rights yields to the child’s right to make their own decisions when they reach a sufficient understanding and intelligence to be capable of making up their own mind on the matter requiring decision”.