Good health care and 'parental rights'

September 6, 2008

The prescription of oral contraceptives to a 14-year-old without her parents' knowledge has triggered a debate over adolescents' access to confidential health care. The student of Bellarine Secondary College in Victoria was taken by a school nurse to a doctor, who prescribed the medication.

The school has supported the nurse's decision, arguing that the Health Act binds medical professionals to patient confidentiality. However, the student's mother claims that she has been robbed of her "parental rights". The August 28 Geelong Advertiser reported the mother saying, "Just what exactly am I entitled to know? My daughter needs real education on relationships and sex and she is not mature enough to make that decision alone".

Premier John Brumby chimed in, saying that the school should have consulted the student's parents before assisting her to get the pill and that the failure to do so demonstrated a lack of moral judgement.

What has been glaringly absent from this heated discussion is what young people themselves think about the issue. Clinical evidence that illustrates the importance of confidential health care for young people has also been ignored.

A 2005 article in the Medical Journal of Australia cites a US study that found that 60% of girls aged 12-17 years reported that they would stop using all or some sexual health services, or delay testing or treatment for sexually transmitted diseases, if their parents were notified. Similar studies consistently show that the overwhelming majority of teenagers want to be able to obtain health care without parental knowledge.

This indicates the importance of protecting young people's medical confidentiality. The alternative would place an enormous barrier between young people and medical attention, resulting in serious health repercussions throughout society.

Under existing laws, a medical practitioner must provide confidential care to a person of any age if they deem the patient mature enough to understand the issues involved. The only exceptions are if a health professional has reason to believe the patient is at risk of harming themselves or someone else, or is at risk of being harmed by someone else (in cases of abuse involving children aged 16 or under).

The mother of the 14-year-old at the centre of the current debate said, "All these privacy regulations do is break down the relationships between parents and their children". Yet the regulations exist simply to ensure that all patients can access health care. If a young person does not feel comfortable discussing contraception with their parents, it likely reflects on the quality of that relationship and has nothing to do with the confidentiality regulations.

There is little value in parental involvement in such decisions if a strong and supportive relationship to base that involvement on doesn't exist. As the article in the Medical Journal of Australia argues, it is not family values that are in conflict with providing confidential health care for adolescents, but outdated views on parental rights.

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