HIPPA and Parents of Minors - page 3

by vintagemother 19,403 Views | 35 Comments

I'm a prenursing student and a mom. A friend of mine just was told that due to new HIPPA laws, she could not go into the physical exam room with her 12 year old son. Is this a new law? Or did the person at the Doctor's office... Read More


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    You have a right to receive HIPAA disclosures, in fact you have to sign saying you received their HIPAA pamphlet. Look through it and ask them to point at the part that gives them this right.

    However, the parent should not be part of the full physical exam for a 12 year old. This is a very sensitive time and change for a child and it is embarrassing enough to have an adult looking at and touching your genitals, to have a parent present can be too much of a privacy invasion.
    r.dav and Altra like this.
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    RE: "it is embarrassing enough to have an adult looking at and touching your genitals, to have a parent present can be too much of a privacy invasion."

    So, in your mind, because having your private areas touched can be embarrassing and an invasion of privacy, strangers (medical workers) should be allowed to do this with kids without their parents in the room?

    I, politely, disagree.

    I think it can be very difficult for adults, let along children, to speak up and advocate for themselves, to a person in authority such as a medical pro, while in a compromising (naked) position.

    I don't mean to start a debate. It's just that I have a real problem with just that exact issue. I don't want to leave the room and my kids be told to do X, Y or Z. I believe that no-one has the right to invade a person's privacy - not your parents or the doctor or anyone else.

    When I paid good cash money to see a specialist, he never would discuss the reasons we were there with me while naked. He knew that being naked on your back with legs open diminishes a person's ability to be an advocate for themselves.

    His attitude suited my style.
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    Quote from vintagemother
    RE: "it is embarrassing enough to have an adult looking at and touching your genitals, to have a parent present can be too much of a privacy invasion."

    So, in your mind, because having your private areas touched can be embarrassing and an invasion of privacy, strangers (medical workers) should be allowed to do this with kids without their parents in the room?

    I, politely, disagree.

    I think it can be very difficult for adults, let along children, to speak up and advocate for themselves, to a person in authority such as a medical pro, while in a compromising (naked) position.

    I don't mean to start a debate. It's just that I have a real problem with just that exact issue. I don't want to leave the room and my kids be told to do X, Y or Z. I believe that no-one has the right to invade a person's privacy - not your parents or the doctor or anyone else.

    When I paid good cash money to see a specialist, he never would discuss the reasons we were there with me while naked. He knew that being naked on your back with legs open diminishes a person's ability to be an advocate for themselves.

    His attitude suited my style.
    Yes, not only in my mind, but it is a standard practice to examine an adolecent without a parent present.

    A 12 year old boy going through puberty does not (in most cases) want his mother in the room while his genitals are exposed and being touched, boys at that age are very self-conscious. I can imagine a 12 year old female would not want her father in the room while she is undergoing a pelvic examination. Although I think their should be a chaperone in the room during an exam. Nurses are patient advocates and can be the chaperones depending on the office.
    Irish_Mist, unclebda, and Altra like this.
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    The pediatrician and even the pediatric dentist who saw my children when they were still minors strongly encouraged parents of adolescents to remain in the waiting room.

    In my state, 13 is the age at which minors do not need parental consent to seek psychiatric services or health care related to birth control, STIs or pregnancy.

    I find some posts in this thread disheartening, in the lack of recognition that a patient will most likely provide accurate answers to questions and get the benefit of health care providers' answers to their questions if they are not accompanied by family. Does a 12-year old boy really want his mother to hear his questions about information he has picked up from friends about his developing body, or the developing body of a girl? Without mom present, he may ask those questions, and get accurate answers, without the family dynamics.

    There was a recent thread on this same topic with adult patients accompanied by spouses, partners and family members. Some recurring comments included something along the lines of, "don't they think I've ever seen his/her body before?" Again ... very disheartening ... the lack of recognition that they way that intimate partners see each other is very different from a clinical examination.
    unclebda, r.dav, and MattNurse like this.
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    I wouldn't think it all or nothing. I think an initial parent/child visit, then parent goes back to waiting room.
    Quote from Altra
    The pediatrician and even the pediatric dentist who saw my children when they were still minors strongly encouraged parents of adolescents to remain in the waiting room.

    In my state, 13 is the age at which minors do not need parental consent to seek psychiatric services or health care related to birth control, STIs or pregnancy.

    I find some posts in this thread disheartening, in the lack of recognition that a patient will most likely provide accurate answers to questions and get the benefit of health care providers' answers to their questions if they are not accompanied by family. Does a 12-year old boy really want his mother to hear his questions about information he has picked up from friends about his developing body, or the developing body of a girl? Without mom present, he may ask those questions, and get accurate answers, without the family dynamics.

    There was a recent thread on this same topic with adult patients accompanied by spouses, partners and family members. Some recurring comments included something along the lines of, "don't they think I've ever seen his/her body before?" Again ... very disheartening ... the lack of recognition that they way that intimate partners see each other is very different from a clinical examination.
    unclebda and r.dav like this.
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    I'd change to a different doctor's office and tell them why.

    Esme - thanks for the detailed information.

    Two different issues here - one the OP asked about HIPAA. The other whether parents should go back to the exam or not.

    The second one depends on the family - my kids heard the details about puberty from good old mom (masturbations, wet dreams, STD's, etc.) I've always been very blunt with my kids. I definitely think I should go back for most things but there are times when a private chat with the doc is a good idea too.

    I do want an advocate for physical exams though - a nurse needs to stand by when the doc does those. To protect the doc and the patient.

    I worked in a physician's office and they need to be very careful. We've had a few local cases where physicians did some unethical things . . . a camera in the exam room for pap/pelvic exams; getting high on "laughing gas" with a MA and having sex in an exam room and she later sued the doc for sexual harassment; a pediatrician who fondled kids . . .. .
    r.dav and nursel56 like this.
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    Quote from morte
    I wouldn't think it all or nothing. I think an initial parent/child visit, then parent goes back to waiting room.
    The dentist did this in reverse ... exam first, then consultation with parent.

    The pediatrician group had the parent present while vital signs were obtained and height & weight checked, to identify any areas of concern and answer screening questions which required parental input.

    I didn't mean to imply that the parent had no interaction at all with the providers.
    r.dav likes this.
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    Thanks for the clarification. I went to doc so infrequently at that age that i can't remember when parent stopped going in with me!
    Quote from Altra
    The dentist did this in reverse ... exam first, then consultation with parent.

    The pediatrician group had the parent present while vital signs were obtained and height & weight checked, to identify any areas of concern and answer screening questions which required parental input.

    I didn't mean to imply that the parent had no interaction at all with the providers.
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    vintagemother-

    I spent some time reviewing the laws that relate to minor consent in California. The bulk of those guidelines were published in 2002. There is a law under consideration that Governor Brown has not signed yet, AB 499 that adds the ability for a minor to consent to treatment of STDs, the main purpose of which is to be able to get the Gardisil vaccinations for the prevention of cervical cancer without parent's consent.

    The purpose of the laws is to allow a minor to consent to treatment themselves, without the permission of the parents or legal guardians. It isn't meant to try to cut the parents out of the process, which is not standard practice in California nor does the law require that children be examined without the parent present.

    Parents and/or providers may prefer to speak with the child alone, but again there is no legal requirement that this occur, which makes sense when you consider how vastly different both provider's personalities are and the developmental stage an adolescent child is in. As someone who is a parent and worked for many years with kids, both inpatient and outpatient, I know such a blanket requirement could end up being as harmful as it can be helpful. That's why the power to choose who the provider is and when to discontinue seeing an individual provider is left to the parents or legal guardians.
    Last edit by nursel56 on Jun 10, '12
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    Thank you for the additional information, nursel56.

    Spidey's mom: Re: "my kids heard the details about puberty from good old mom (masturbations, wet dreams, STD's, etc.) I've always been very blunt with my kids. I definitely think I should go back for most things but there are times when a private chat with the doc is a good idea too" for the most part, this describes how I feel and what I've done, as well.

    Altra: RE: "...the lack of recognition that a patient will most likely provide accurate answers to questions and get the benefit of health care providers' answers to their questions if they are not accompanied by family."

    Respectfully, I'd like to explain that the problem I personally have is a child isn't always the best advocate for him or herself. Some adults have trouble advocating for themselves at a doctor. With a child, you have lots of other dynamics at play-age, social status, authority, etc.

    Another relevant issue is that every adult does not have the same moral and ethical lifestyle that I want my children exposed to. As an example, my health plan gives a handout to 12 year old children detailing and explaining alternative lifestyles. Parents are not provided with the same copy of the same document.

    For me, as a parent, I want my children to be given facts. I want their questions answered and I'm okay if they get a different perspective from another adult besides myself. However, sometimes different adults have different lifestyle choices and these personal feelings can impact the info a kid is given. One adult might think it's okay for kids to have sex with whomever as long as they use condoms and birth control. Another adult might tell a child to wait until they area emotionally ready. Another medical person might discuss "mutual monogamy".

    I give my kids facts, but I have a certain expectations for behavior. Some adults have a different expectation. I think most parents and professionals know that children often rise to meet our expectations. My expectation might be totally different than that of the physician treating the child. It's one thing when a child has a question to ask the doctor or health care worker; it is a different matter (in my opinion) when the medical professional tells the child their beliefs and provides medical care based on that.
    Last edit by vintagemother on Jun 16, '12


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