Confidentiality for teenagers: can your doctor keep a secret?

Dr Margaret [biog] answers users' embarrassing problems in this problem page feature (new products every 2 weeks)

Are you a teenager with a health problem that you don’t want your mother or father, or anyone else for that matter, to know about? It might be a sex problem, or wanting to go on the pill, or worries about drugs, alcohol, pregnancy or bullying at school, or feeling depressed. Are you concerned that if you talk to your doctor, your parents might be told? Or that the doctor will have to ask your parent’s permission before treating you (such as prescribing the contraceptive pill or the ‘morning-after’ pill, or arranging an abortion)? Or that someone might see you in the doctor’s waiting room and report back to your parents? Or that the doctor’s receptionist or nurse might gossip to others about your problem? Or that, if you need a prescription, someone will see you in the chemist? Or that the doctor will write to you at home - maybe with test results - and your parent will see the letter?

We have had quite a few emails from teenagers worried about seeing their doctor for these reasons. So here are some facts.

Does your GP have to get your parent's permission to give you treatment?

If you are over 18, there is no problem - you are an adult, and your parents don’t have to give permission for any type of treatment. If you are 16 or 17, the situation is almost the same, except that the GP has to make sure you are ‘competent’ to make decisions about your own treatment. This simply means that you are able to understand the treatment and the effects it might have on you.

If you are under 16, the law says that you can make your own decisions about treatment - including contraception and abortion - without your parent’s permission if:

So if you are under 16, the GP will talk to you about the problem and treatment to find out if you are ‘competent’ to make the decision yourself. The GP will also ask why you don’t want your parents to know, and may suggest that you talk to your parents about the problem. The GP has to do this by law. But if you say that you definitely don’t want your parents to be involved, the GP cannot force you to tell them. Nor can your GP tell your parents without your permission, even though you are under 16 (except in very exceptional circumstances mentioned below). Then the GP has to decide if the treatment is ‘in your best interests’ - is it the right thing for you?

This discussion may sound a bit scary, but don’t let it put you off. All the GPs I’ve talked to are very concerned about the health of teenagers, and really do want teenagers to feel they can go to see their doctor without worrying. So your doctor will probably be very kind and sympathetic. If you would rather speak to a different doctor, tell the receptionist and this can be arranged. If you are very unlucky and your GP is not helpful about a sex or pregnancy problem, you could contact Brook (www.brook.org.uk): they provide free, confidential sex advice for young people under the age of 25. Their freephone young people’s helpline number is 0800 0185023. For other problems, you can contact Childline (www.childline.org.uk). There freephone confidential number is 0800 1111.

Will the GP, receptionist or nurse tell anyone else - such as your parents?

Anything you discuss with the GP, any treatment you have and the results of any tests stay confidential. This means that the GP, nurse, receptionist or anyone else working in the practice must not pass the information on. Even if you are under 16, nothing can be said to anyone - your parents or anyone in your family, care workers, college tutors - without your permission. Even if your parents are very friendly with the GP, the GP is not allowed to talk about you without your permission. The GP, or anyone else in the practice, will not even say whether or not you have visited the surgery. The only reason the GP might have to pass on confidential information without your permission is to protect you or someone else from very serious harm. This is a very unusual situation, and the GP would always try to discuss it with you first.

If you want to be really sure, ask the receptionist for a copy of the ‘practice leaflet’. Most practices have one, giving details of surgery times and other information, and it may contain a statement about confidentiality. And when you see the GP about your problem, you could mention your concern by saying ‘I want this to be confidential’.

What about being seen in the waiting room, or at the chemist with a prescription?

There is no way round this difficulty. Of course someone might mention to your parents that they saw you at the doctor’s, so you should be prepared for a few questions. The same goes for the chemist, but try to choose a time when the shop is empty. Like the doctor, the chemist is not allowed to give information about your prescription to anyone else.

Acknowledgement
The Royal College of General Practitioners is very keen that teenagers should be able to trust their doctor, and held a conference on ‘Young People and Confidentiality’ on 30 November 2000. Some of the above information is from that conference, and from the accompanying training pack for doctors produced with the help of Brook.

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