Question

write a 400-word post to utilize critical thinking to provide a rationale of whether parents should be informed of all information related to their minor child when contact tracing. Should certain infections and/or information that is part of contact tracing, be withheld from parents? List the items that you believe are acceptable to withhold from parents (if any) and only to provide information to the minor, and the types of information or infections that should always be shared with parents.

Answer 1

Any decision to delay in sharing information with the parents where a child or young person is at risk of or is suffering, abuse or neglect must be taken cautiously and only in circumstances where the increased risk to the safety or welfare of the child or young person clearly outweighs the advantages of sharing information. You must be able to justify your decision for not sharing information. You must record the decision not to immediately share information, along with your reasons and any advice you have received.

If exceptionally, you decide that sharing information immediately with the local authority children’s services or another appropriate agency would not be in the child’s or young person’s best interests, you should discuss this with the child or young person, or their parents. You must keep in contact with the child or young person and regularly review the decision to delay sharing information. You must try to make sure that the child or young person gets the care and support they need.

Minors can and should participate in medical decision making commensurate with their developmental level and ability. However, the concept of informed consent has only limited application in pediatric care. Only competent minors with legal empowerment have the ability to give true informed consent to medical treatment. In other situations, a parent or guardian acting as a surrogate provides informed ‘‘permission’’ for medical treatment with the assent of the child whenever possible. Pediatric healthcare providers may face problems with surrogate decision making. Although the law provides parents and guardians discretion in raising their children, their religious and social beliefs may interfere with the best interests of the child. When this occurs, healthcare providers must look to the state and the legal system for answers. When a minor is deemed incompetent and unable to give informed consent, giving assent allows the adolescent’s voice to be heard and promotes the perception of empowerment via participation in medical decision making. The assent process should include the following:

1. a developmentally appropriate explanation of the medical condition and the treatment

2. an assessment of the minor’s understanding of the information and how his or her decision was made

3. an expression of the minor’s willingness or unwillingness to allow treatment

Physicians who treat minors have an ethical duty to promote the developing autonomy of minor patients by involving children in making decisions about their health care to a degree commensurate with the child’s abilities. A minor’s decision-making capacity depends on many factors, including not only chronological age but also emotional maturity and the individual’s medical experience. Physicians also have a responsibility to protect the confidentiality of minor patients, within certain limits.

In some jurisdictions, the law permits minors who are not emancipated to request and receive confidential services relating to contraception, or to pregnancy testing, prenatal care, and delivery services. Similarly, jurisdictions may permit unemancipated minors to request and receive confidential care to prevent, diagnose, or treat sexually transmitted diseases, substance use disorders, or mental illness.