Introduction to medical confidentiality for adolescents

Abstract

Introduction: this article addresses the scope of medical confidentiality for patients under 18 from a legal perspective. The topic is highly complex, not only due to casuistics, but also because of the scarce medical confidentiality regulations. If debates on the scope of medical confidentiality in patients of age are frequent, the scope of medical confidentiality for adolescent patients is especially controversial.
Objective: this study aims to prove that within the Uruguayan legal framework, patients that are under age have the right to medical confidentiality when they are mature adolescents. With the purpose of reaching this conclusion we shall combine both the medical concept of mature adolescent with the international conventions on the rights of the child and youngsters that were ratified by Uruguay, in order to establish not only medical criteria but also a legal minimum age to have the right to confidentiality with regard to those who possess their parental authority or guardianship and to court requests for medical records.
Conclusions: upon our analysis we arrived at the following conclusions:
a) children between 12 and 18 are protected by medical professional secrecy;
b) children between 15 and 18 may even enforce professional secrecy against their parents or tutors;
c) in terms of sexual and reproductive rights, adolescents between 12 and 18 may seek confidential counseling for contraceptive methods;
d) girls between 15 and 18 may, under certain circumstances, request confidentiality concerning their parents within the framework of pre and post abortion counseling programs;
e) in order to take part in such programs, the girls between 12 and 15 need to have parental consent;
f) the rights of children and adolescents under age partially limit medical secrecy on account of the guardianship principle, in the case of denial for treatment of serious conditions or due to religious reasons;
g) within the above mentioned age limits, physicians shall evaluate the maturity of minors in order to be protected by professional secrecy.