What Are Doctors Asking Teen Patients About?
Should parents be listening in when doctors ask their teenage sons and daughters medical questions? At what age are "tweens" and older teens entitled to some medical privacy? A recent Associated Press story, republished in the Chicago Tribune, asked precisely these questions.
The article goes on to suggest that many parents are asked to step out of the room so that teens feel comfortable sharing sensitive information about sexual activity or other health behaviors so that doctors have the full picture and can provide appropriate care without fear of repercussions for teens. The ethical line is where a teen could be hurt or unsafe, says the American Academy of Pediatrics physician in the story. ""If we are concerned that someone is in danger, we are compelled to share that information."
So what are the big topics? Sex and sexuality, alcohol and drugs, mental health problems, using proper traffic safety measures, including wearing seat belts, and vaccinations are the ones listed in the article. That seems to cover a fairly wide range of public health topics--and seems consistent with the major problems plaguing teens and 20-somethings today.
As for the ethics, I think the practice of asking parents to leave the room in the "tween" years is just about right. Creating a sense of promoting patient autonomy and privacy at the age of 12-14 will help to foster a sense of empowerment as a patient and to create a trusting physician-patient relationship at an early age. Parents should teach their children how to ask questions of physicians and model such behavior for them so that they learn how to interact with the healthcare system and navigate it well, and to encourage independent interaction with healthcare practitioners. So long as parents are not offended when asked to leave the room, tweens and teens will see this as an opportunity to become a patient in their own right. This time alone with the physician will promote not only autonomy but self-confidence in the physician-patient interaction and over the long-term will promote, in my view, a more empowered, self-reliant patient in the adult years as well.
Letting "tweens" have their own independent relationship with their physician, therefore, is not only good for allowing physicians to have correct information about the patient's health behaviors and allow tweens and teens to ask their own questions without parental interference, but over the long-term is much more likely to result in a patient who knows how to communicate with physicians over their lifetime.
Summer Johnson, PhD
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I think the tween or teen should be asked if they want their parents to leave the room. Knowing my daughter, she would have thought it creepy as hell if I were asked to leave the room and the doctor, esp. if male, started talking to her about sex.
As to other benefits - I don't know if talking to a doctor alone at 14 is any more likely to result in a patient knowing how to communicate with physicians over her lifetime than talking to a doctor alone at 18 is. At 14 my kid could hardly be made to open her mouth. Doctor: "Your stomach hurts?" Kid: "...". At 18 it was a different story.
- by Laura(southernxyl) on Mar 29, 2009 at 6:26 PM | link
A significant moral issue is WHO knows what is best for the child, at any age. Assuming the 14 year old doesn't know what is best, you're left with the doctor and the parent. If the parent is morally responsible and the doctor a moral relativist, the parent should be there ALL the time. A degree in medicine has NOTHING to do with ethics or moral integrity... unfortunately. And "age" has nothing to do with knowledge, understanding or wisdom... again, unfortunately. Now, if the parent is morally irresponsible (as some are), and the doctor the opposite, I still say it's a good idea to have the parent there as long as they're paying the bills. Perhaps the doctor can then knock some sense into the parent: "No, Mrs. Robinson, your 14-year old Jenifer should not be dating a 28 year old man, even if you do like him."
- by Stan Williams, Ph.D. on May 11, 2009 at 2:59 PM | link