A 17-year-old girl comes to the office for evaluation of worsening vaginal irritation and discharge. She has had multiple sexual partners in the past few months. The patient is adherent with oral contraceptives and inconsistently uses condoms. She has no prior medical conditions and takes no other medications. Urine pregnancy test is negative and urine gonorrhea test is positive. The patient does not want her parents to find out she is having sex and asks if the physician will tell her parents about today's visit. Which of the following is the most appropriate response to this patient?

Question

A 17-year-old girl comes to the office for evaluation of worsening vaginal irritation and discharge.  She has had multiple sexual partners in the past few months.  The patient is adherent with oral contraceptives and inconsistently uses condoms.  She has no prior medical conditions and takes no other medications.  Urine pregnancy test is negative and urine gonorrhea test is positive.  The patient does not want her parents to find out she is having sex and asks if the physician will tell her parents about today's visit.  Which of the following is the most appropriate response to this patient?

Quizplus · Accepted Answer

11ec160b_365b_f470_9249_43aea17673c7_MD0001_00 Minors (age <18) usually require parental consent for medical treatment; however, consent is generally not required in the following situations: Legal or situational emancipation (eg, parent, married) Emergency care in which delay of care could result in significant harm to life or limb Specific conditions (eg, sexually transmitted infection [STI], pregnancy, substance abuse) that are potentially serious, sensitive, or stigmatizing Allowing minors to consent for treatment of certain potentially serious medical conditions (eg, STI) encourages them to seek services without concern of parental involvement, as in this patient's situation. In most states, minors can also consent to substance abuse and mental health treatment as well as reproductive services, although there may be variations among states (eg, requiring minors to be a minimum age). Some, but not all states, also exclude information about sensitive services from insurance documentation that is sent to the parent (policyholder). (Choice A) Notification of parents for STIs other than HIV is not mandated in any state. (Choices B and E) The patient can obtain evaluation and treatment for STIs, including antibiotics, without parental notification or consent. (Choice C) Although it is often preferable for parents to be involved in their child's care, it should not be automatically assumed that disclosing information would be in the patient's best interest. This response also dismisses the patient's concern about confidentiality and fails to answer her question. Educational objective: Minors do not require parental consent for medical treatment of conditions that may be sensitive or stigmatizing such as sexually transmitted infections, pregnancy, and substance abuse. __________ References: Sexual and reproductive health care services in the pediatric setting. (http://www.ncbi.nlm.nih.gov/pubmed/29061870)

A 17-Year-Old Girl Comes to the Office for Evaluation of Worsening