OverRated: Doctor-Patient Privilege and Teenagers

Almost five decades ago, when I was a child, medical treatment for children under the age of 18 would have required the consent of an adult parent or guardian because minors were not considered competent to make any such decision. Unless it was an emergency situation and no parent/guardian could be contacted (as was often the case in the days before mobile phones), when the medical staff on the spot would make any decisions on behalf of the youngster.

However, as I’ve grown up, political correctness has allowed the rights of minors to become paramount, permitting them to make their own decisions and choices about all sorts of matters pertaining to their health – be it physical, mental or sexual. And allowing children a few moments to speak to the doctor privately might stop some of the terrible incidents of abuse that we hear about in the media.

Back in the Dark Ages, when I turned 16, this change in the Law meant that I could obtain the contraceptive Pill and/or condoms from the local Family Planning Clinic without having to involve my parents.

On becoming a mum myself, I still support this ruling wholeheartedly. Even though my relationship with my daughter is far more open than the one I had shared with my own mother – she told me she was going to the clinic to discuss and procure her personal methods of contraception – for her friends, this ability probably prevented a lot of unwanted pregnancies and STDs.

However, I wonder how many other parents are aware of the rules regarding doctor-patient privilege when it is applied to adolescents who visit them for other, more serious matters.

Whilst most of us will have been well aware that contraception and abortion issues can be dealt with by medical professionals without recourse to the parents, did you also know that drugs for depression can be dished out on prescription to your child without your knowledge?.

It’s a difficult and very grey area. At 16, they are no longer children physically but, mentally, they still have a long way to go to reach full maturity. It isn’t rocket science to suggest that a teenager’s analysis of symptoms and situations is not always fuelled by a thorough assessment of all the facts.

To send a sleepless and depressed youngster away from the surgery armed with a prescription for a drug which has the side-effects of insomnia and suicide is worrying enough. To do so without being required to alert the people who are responsible for their day to day care is reprehensible

I would like to think that doctors take into account the rather skewed way that these young people perceive the world and their position in it. Hopefully, when they formulate their diagnosis, they acknowledge that the teenager’s diet will invariably be based regular fast-food and caffeine-heavy drinks, accompanied by a fair of amount of alcohol and narcotic consumption. None of this is going to promote good sleeping habits or a healthy metabolism. But, if questioned, these facts will probably be denied vehemently and, to the juvenile brain, it is not necessarily a falsehood, merely that their perception of their diet is that it is not unhealthy or that it does not affect their mood or insomnia.

I am sure that doctors and counsellors also take into account the hormonal imbalances, party animal syndrome and general ‘I want it now’ attitude of most teenagers.

I would hope that most doctors would warn explicitly about the dangers of combining any prescription medication with alcohol or any other social drug use and the fact that anti-depressants can cause drowsiness, so driving or operating machinery should not be undertaken.

But the most worrying part about this is that, if the parent does find out or is told by the child, if they call the surgery, they will not receive any information to help them to guide their child with the usage of the drug unless that child goes to the surgery and withdraws the confidentiality.

And then I think, well, is it really any different from being precluded from any say in a child’s contraceptive choices? 16 year olds are allowed the privilege of being treated as ‘mature minors’ who are able to give ‘informed consent’ to accepting such aids, even down to a surgical procedure like an abortion.

But at least the latter is performed in a hospital under the care of the medical professionals. When your child is out ‘clubbing’ on prescription medication and you have no control over their consumption of other extraneous substances, it is the stuff of nightmares…

… and the moment when you realise that your child has thrown off any parental restraints — with the full permission and collusion of that childhood authority figure, the local doctor.