Paeds Cases · adolescent-and-young-adult-medicine
Adolescent consent for research and sensitive services — OSCE communication station
Observed structured encounter testing research-enrolment consent (assent plus parental permission, waiver of parental permission), sensitive-services consent, bedside capacity assessment, and a lawful, ethical confidentiality override.
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Target exams
RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
Station A is recruitment of a 14-year-old into an anonymous sexual-health survey under a proposed waiver of parental permission. Station B is a sensitive-services contraception request followed by a private disclosure of an active suicide plan requiring a lawful, ethical override of confidentiality.
Station objectives
- Present a research study developmentally and obtain age-appropriate assent; recognise when a waiver of parental permission is justified. [2] [6]
- Run a sensitive-services consent encounter: time alone, conditional confidentiality, bedside capacity assessment. [14] [11]
- Override confidentiality ethically when a safety threshold is crossed. [11] [10]
- Protect sensitive content and study data across records, portals and billing. [12] [11]
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References14Show ledgerHide ledger
- [1]Katz AL Informed Consent in Decision-Making in Pediatric Practice. Pediatrics, 2016.PMID 27456510
- [2]Santelli JS Guidelines for adolescent health research: a position paper of the society for adolescent medicine. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 1995.PMID 8924431
- [3]Wendler DS Assent in paediatric research: theoretical and practical considerations. Journal of medical ethics, 2006.PMID 16574878
- [4]Grady C Assent in research: the voices of adolescents. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 2014.PMID 24630932
- [5]Grady C Adolescent Research Participants' Descriptions of Medical Research. AJOB empirical bioethics, 2016.PMID 27004235
- [6]Bauman LJ Whether to Waive Parental Permission in HIV Prevention Research Among Adolescents: Ethical and Legal Considerations. The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics, 2020.PMID 32342775
- [7]Hein IM Informed consent instead of assent is appropriate in children from the age of twelve: Policy implications of new findings on children's competence to consent to clinical research. BMC medical ethics, 2015.PMID 26553304
- [8]Nakalega R Ethical considerations for involving adolescents in biomedical HIV prevention research. BMC medical ethics, 2021.PMID 34556099
- [9]Francis JKR Research Participation of Minor Adolescents in Foster Care. Journal of pediatric and adolescent gynecology, 2021.PMID 33333259
- [10]Ford CA Influence of physician confidentiality assurances on adolescents' willingness to disclose information and seek future health care. A randomized controlled trial. JAMA, 1997.PMID 9307357
- [11]Chung RJ Confidentiality in the Care of Adolescents: Policy Statement. Pediatrics, 2024.PMID 38646690
- [12]English A Adolescent Consent and Confidentiality: Complexities in Context of the 21st Century Cures Act. Pediatrics, 2022.PMID 35531643
- [13]Santelli JS Discussion of Potentially Sensitive Topics With Young People. Pediatrics, 2019.PMID 30651304
- [14]Dickens BM Adolescents and consent to treatment. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2005.PMID 15847892