Paeds Cases · adolescent-and-young-adult-medicine
Consent and confidential care for adolescents — OSCE communication station
Observed structured encounter testing time alone, conditional confidentiality, bedside capacity assessment, lawful override and electronic-record confidentiality.
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Target exams
RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
Station A is a contraceptive request from a 15-year-old who asks that her mother not be told. Station B is a private disclosure of an active suicide plan requiring a lawful, ethical override of confidentiality.
Station objectives
- Negotiate time alone and state conditional confidentiality with honest limits. [2] [4]
- Assess adolescent decision-making capacity at the bedside. [6] [7]
- Obtain valid informed consent (capacity, information, voluntariness). [5]
- Override confidentiality lawfully and ethically when a safety threshold is crossed. [4]
- Recognise and prevent electronic-record confidentiality hazards. [8]
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References8Show ledgerHide ledger
- [1]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
- [2]Ford CA Delivery of confidentiality assurances to adolescents by primary care physicians. Archives of pediatrics & adolescent medicine, 1997.PMID 9158445
- [3]Miller VA Adolescents Spending Time Alone With Pediatricians During Routine Visits: Perspectives of Parents in a Primary Care Clinic. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 2018.PMID 29887486
- [4]Chung RJ Confidentiality in the Care of Adolescents: Policy Statement. Pediatrics, 2024.PMID 38646690
- [5]Katz AL Informed Consent in Decision-Making in Pediatric Practice. Pediatrics, 2016.PMID 27456510
- [6]Weithorn LA When Does A Minor's Legal Competence To Make Health Care Decisions Matter? Pediatrics, 2020.PMID 32737229
- [7]Steinberg L Does recent research on adolescent brain development inform the mature minor doctrine? Journal of medicine and philosophy, 2013.PMID 23607975
- [8]English A Adolescent Consent and Confidentiality: Complexities in Context of the 21st Century Cures Act. Pediatrics, 2022.PMID 35531643