Minor's right to refuse

  1. If you have a patient's parent who is requesting her daughter to be put on birth control when the daughter says she is not having sex, how can you diplomatically handle it? Id never want to force a patient to do something, but want to avoid parent hostility.
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  2. 16 Comments

  3. by   BackfromRetirement
    The parent should be referred to the primary physician. This is between the parent and the MD. Chart the request and the referral.
  4. by   emsboss
    Quote from BackfromRetirement
    The parent should be referred to the primary physician. This is between the parent and the MD. Chart the request and the referral.
    I agree with this statement... This seems the best way to remain diplomatic
  5. by   Mary C
    But how do I say it to the mom and teen without coming off rude or uncaring?
  6. by   canoehead
    Mom wants it, but has the teen refused it?

    Have they both gotten teaching on the risks/benefits? As a teen the thought of lighter periods would sell me, and as a mom, the fact that it doesn't prevent disease, and needs to be taken like clockwork to be dependable might sway me in the other direction.

    My understanding is that if someone able to understand all the risks and benefits refuses, then they don't have to submit to a parental decision. Remember that teens can obtain care for sexual health without any parental notification. Talk to the teen alone to find out for sure what her needs are.
  7. by   HiHoCherry-O
    I agree with BackFromRetirement. It seems as though more education needs to take place between the mother and the daughter, which may best be handled via the physician. There are advantages and disadvantages to taking birth control.

    I would just tell them that it sounds like more conversation needs to take place. I don't think that encouraging open dialect to come to a better understanding of the situation at hand is rude or uncaring.

    Also. . .I can only speak for the state I live in but I'm sure this may apply elsewhere, when it comes to reproductive health/complaints, minors do not need parental consent. The daughter can make the decision for herself.
    Last edit by HiHoCherry-O on Jun 3, '10 : Reason: additional info
  8. by   BackfromRetirement
    Quote from Mary C
    But how do I say it to the mom and teen without coming off rude or uncaring?
    You can say; I will be happy to pass this along to your attending physician. I feel certain he can address your concerns to your satisfaction.
  9. by   Esme12
    Quote from Mary C
    If you have a patient's parent who is requesting her daughter to be put on birth control when the daughter says she is not having sex, how can you diplomatically handle it? Id never want to force a patient to do something, but want to avoid parent hostility.
    I don't know what circumstance you are in.......is this teen an emancipated minor or a parent? Even as a minor you cannot force teen to take meds against her will. I would acknowkedge the mothers opinion and try to see what her motivation is and why the teen is refusing. Obviously this has been a discussion in their house! Let Mom know you hear her very clearly and are concerned tha they do not agree and there is conflict. Be very clear about educating them both and that you will let the PCP know of their request and conflict so they can all discuss it with the MD.....Be understanding, supportive, and professional.
  10. by   healthstar
    Quote from Mary C
    But how do I say it to the mom and teen without coming off rude or uncaring?
    You can also say that you are a nurse and you cannot write prescriptions therefore, you need to talk with your daughters physician about this. I don't think you can come off rude by telling her to talk with a physician.
  11. by   gr8rnpjt
    Unless medically necessary (as in, low H&H related to abnormal uterine bleeding) I don't think there is any way the Mom can force the daughter to take the pill. That being said, the doctor and nurse can only advocate for the child. legally, the doctor can refuse to prescribe the pill, but the mom can go to another doctor who has less concern about it and get the prescription. bottom line, mom may be able to obtain the pill for the child but the child is the person who has to swallow that pill every day.

    I would ask mom why she insists on the child being on the pill? Does the child have a boyfriend and are they talking/trying to have a baby at her young age? That would require a conversation with the child. Nurse or Doctor could sit down with her and discuss the realistic facts of this. If it is something Mom just wants on a whim like she wants to show how progressive she is, then all the girl has to do is convince Mom that getting on the pill is exactly what she wants and perhaps mom would have second thoughts...
  12. by   SunnyAndrsn
    Quote from Mary C
    If you have a patient's parent who is requesting her daughter to be put on birth control when the daughter says she is not having sex, how can you diplomatically handle it? Id never want to force a patient to do something, but want to avoid parent hostility.

    Did you ask the mom how she planned on forcing the child to take the pill every day? My mom would have laughed, LAUGHED at the thought of trying to force me to take anything as a teenager.
  13. by   Mary C
    Here's the full scoop. I'm a RN now, but eventually I will be a FNP (God willing!) after I complete my classes. I know how to pass the buck to the Doctor, but it got me thinking about when I can't pass the buck. How do I get Mom out of the room? Or if mom refuses to leave the room to let me discuss with her daughter, how the heck do I handle something like that?

    I guess I have a long enough way to go with school, that I'm just trying to figure out how to troubleshoot before I am in that situation! (Does that make sense?)
  14. by   canoehead
    I've never had a parent refuse to step out when I needed to talk to a teen. Just ask her. If you can't have a private conversation with the teen you can't be sure of getting the full story-and you can't prescribe/treat.

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