Tuesday, March 11, 2008

Sex and Silence

Doctor-patient confidentiality.

Think about that phrase for a minute. Think about what it means. Think about everything that it implies. You can say anything to your doctor, and they cannot reveal it to anyone. There is a similar protection for clergy members and attorneys. These are professions that require candor to effectively do their job, and society has recognized this and provided protections for the individuals who serve in these capacities.

Today, this principle seems to conflict more and more with the idea of parental control over their minor children. Today, confidentiality does not apply to teenagers, and issues over parental notification laws for abortions have gone all the way to the Supreme Court. This presents doctors with a huge problem, however. A new study has been released saying that 1 in 4 teenage girls in the United States have a sexually transmitted disease. To put that in raw numbers, more than 3 million girls between 14 and 19 have an STD. Dr. Margaret Blythe of the American Academy of Pediatrics committee on adolescence says that there are many doctors who do not want to discuss these issues with their teenage patients, or tell them to get tested, as the results of these tests would have to be released to their parents.

This should present on obvious solution to the problem at hand, or at least to this particular piece of the puzzle. I agree 100% wholeheartedly with the American Academy of Pediatrics on their recommendation that teenagers be allowed confidential screenings. Many teens do not want their parents to know that they are having sex, but they still need medical advice. And teens in this situation should not be forced to go into a new situation, with strangers they have never met, in order to get advice and treatment. The Haight Ashbury Free Clinics serve an important purpose, and should be imitated throughout the country/world (I know, I'm a dreamer). But teens should not have to go to the clinics to get advice. Instead, they have to be able to go to a doctor they know and trust, secure in the knowledge that they can get the treatment and advice they need, without being subject to the wrath of their parents.

Whether we like what teens are doing or not, the fact is that they are going to do these things. Sex and drugs and other things are facts of life. The best way to help is not to cover our eyes and ears and scream "HELL BOUND" like the Christian Right, but instead to deal with reality as it presents itself to us. It is time to be realistic, and we need doctors to be able to give advice to teens. We would not stand for a doctor giving our information to someone else, why would we stand for them being able to give someone else's information to us?

And yes, I do understand the counterargument. Parents are responsible for their children, we would never let a doctor perform an operation without consulting a parent, yada yada yada. And part of a doctor's advice should be to encourage a sexually active teen to talk to his or her parents. As far as I am concerned, however, if I had a teenager, it would be more important to me for my teen to be healthy and safe, and cared for by a doctor I know and trust, even if that doctor would not tell me things I think I need to know.

This report by the CDC shows that it is long past time for confidential testing for teens. Hopefully this becomes reality, and we can see these numbers drop in years to come.