Ethical Question- What would u do?

morte, LPN, LVN · Aug 31, 2007

it would seem to me the parents hold all the legal cards here.....though it certainly isnt going to do anything to improve the parent/child relationship

core0 · Aug 31, 2007

What is the appropriate thing to do ethically when a parent asks you to drug test their 14 yr. old without the teens consent? Who takes presidence? Teen? Parent? Would like to hear some of your thoughts...

There are a couple of issues here. The first, is the patient an emancipated minor? If so then all the issues for adults apply. Assuming they are not, there are a couple of further issues. In the area of confidentiality, there are a couple of ways of looking at pediatric patients. If the patient is over 18 or emancipated they are treated as an adult. If the patient is an adolescent (usually defined as over 12-14 but under 18) in some states they are given a say in their care (these are also known as mature minors). Issues that they generally can consent to include emergency care, reproductive issues (parental notification may be required for abortion) and substance abuse.

There are a number of ethicists that maintain since the minors consent is sufficient for substance abuse treatment that there consent is required to release the results.

Also remember your primary duty is to the patient. There is no requirement to treat the parent (although sometimes it would be nice;)). If you feel that the patient would not consent or it is not in the best interest of the patient you are within your rights and should refuse. I would be hard pressed to think of a situation where I would do this outside of a court order.

Here us a nice article on the subject from Mass General Childrens:

http://www.massgeneral.org/children/adolescenthealth/articles/aa_confidentiality.aspx

David Carpenter, PA-C

BarbaraNP · Sep 3, 2007

good answers here. unfortunately, there is not one right answer. david has made some excellent points.

as the article points out, your state law may vary. wa states to be pretty progressive in terms of the rights of minors.

when i see a teenager for the first time, i notify the teen and their parents about their rights to confidentially, and what the law states. i make it clear that my duty on such matters is to the teenager. i've never had a parent balk...most are relieved to have this out in the open.

i think i've been lucky to have never had this kind of request. in this situation, i'd probably talk with the parents about the consequences of such a request. given the law in our state, i'm not sure i could test the teenager without consent. it would be the same as having the teen have an abortion potential against their will because the parents insist.

barbaranp

Jerico, BSN, RN · Sep 13, 2007

Being the parent of six, going through six teens:

Logically, I think it would be in the BEST interest of the TEEN to do the test.

I'd wager parents usually don't ask someone to TEST their teen unless they have a pretty good suspicion?

I have to go with best interest of TEEN....the parents know him better than I....

eymilin, MSN · Sep 29, 2007

I know of a case where the parents asked the provider to test their teen for marijuana. It was negative for pot but turns out the patient (