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Healthcare providers must strike a balance between confiden- tiality and responsibility to parent and patient. And privacy and confidentiality take on specific meanings in healthcare. Privacy is defined by the Center for Adolescent Health
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Care and the Law as the ability of the individual to maintain information in a protected way. Confidentiality in healthcare is the obligation of the provider not to disclose information. A minor’s confidentiality is protected under the Family Educational Rights and Privacy Act (FERPA), Title X and Health Insurance Portability and Accountability Act (HIPAA). Enacted in 1974, FERPA gives parents access to a child’s education records, an opportunity to seek to have the records amended and some control over the disclosure of information from the records. Since its inception in 1970, the Title X program has been the only federal grant program dedicated solely to providing individuals with comprehensive family planning and related preventive health services. As a publicly-funded program, Title X offers patients protection by requiring that programs are voluntary and confidential. HIPAA, enacted in 1996, protects the privacy of individuals’ health information, medical records and embodies important protections for minors, along with a significant degree of deference to other laws (both state and federal) and to the judgment of providers. Under HIPAA, a parent or legal guardian is considered a
personal representative of the minor and is entitled to access the minor’s personal health index. There are, however, three situations in which a parent does not have the automatic right to access a minor’s medical records.
on state laws. A physician, however, can make the clinical decision to inform a parent. * The minor has a legal right to consent. This will vary based
* The minor can legally receive care without parental consent. * The parent agrees to an agreement of confidentiality between the minor and provider. Providers who believe that particular patients might hurt themselves or someone
else have a legal obligation to notify law enforcement authorities, but they can also inform family members if they feel family members may be reasonably able to prevent or lessen the risk of harm. A provider’s “duty to warn” generally is derived from and defined by standards of ethical conduct and state laws. HIPAA further permits a covered provider to notify a patient’s family members of a serious and imminent threat to the health or safety of the patient or others if those family members are in a position to lessen or avert the threat.
Ready, Set, Grow 87
s a parent, it’s always difficult to walk that fine line be- tween privacy and responsibility as your kids get older.
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