Pediatric Informatics: Computer Applications in Child Health (Health ...

22 Privacy Issues 309
and receipt of the fax. Include standard fax privacy and intended addressee notices
on all fax communications, and disclose (and document) any errors in delivery.
22.4.9 Sharing Local Adolescent Health Privacy Laws
with Patients and Staff
Although adolescents under age 18 are legally minors (depending on the jurisdiction),
there are precedents which permit them to consent to health services:
Specific statutes empower minors to consent for pregnancy care as well as
confidential contraception, STI/HIV testing and treatment, alcohol and drug
abuse treatment, and mental health counseling and treatment.
Legally emancipated minors are those: (a) serving in the armed forces, (b) living
away from home and managing their own financial affairs, or (c) who are or have
been pregnant or are parents.
By common law doctrine, mature minors demonstrate sufficient cognitive maturity
to understand the risks and benefits of proposed medical treatments and
alternatives, and can thereby voluntarily and responsibly consent.
Exceptions to confidentiality may include situations where an adolescent
patient:
� Is suicidal/homicidal or poses a danger to self or others
� Is a victim of sexual or physical abuse
22.5 Conclusion: The Place of IT in Information Assurance
The protection of child and adolescent privacy and of PHI security is complex in
pediatric care because of the different and changing patterns of authorization that
occur over the lifetime of the child. In assuring these protections, the design and
implementation of health IT must incorporate and enforce the basic premises of
information assurance and HIPAA while taking into account developmental and
chronological differences.
References
1. Gostin LO. National health information privacy: regulations under the Health Insurance
Portability and Accountability Act. JAMA. 2001;285(23):3015–3021.
2. Hoffmann AD, Greydanus DE. Chapter 6: consent and confidentiality. In: Adolescent
Medicine. 3rd ed. Stamford, CT: Appleton & Lange; 1997.
3. American Academy of Pediatrics Committee on Adolescence. Achieving quality health
services for adolescents. Pediatrics. 2008;121:1263–1270.