Late adolescents’ own and assumed parental preferences towards health-care related confidentiality and consent in Belgium

Abstract

Objectives Health care professionals regularly struggle with issues relating to confidentiality and consent for physical and/or mental health issues among adolescents. We investigate late adolescents’ own and assumed parental preferences towards health-care related confidentiality and consent. Methods We analyzed online survey data of four vignettes from 463 first-year university students at KU Leuven (Flanders, Belgium). We used paired samples t-tests to assess the (in)consistency between attitudes of late adolescents and their assumed parental attitudes, independent samples t-tests to estimate gender differences, and binomial logistic regressions to analyze the association of assumed parental preferences with late adolescents’ own preferences. Results Attitudinal inconsistencies were present in all vignettes. Late adolescents were significantly more in favor of confidentiality and adolescent consent than what they believed their parents were. Gender differences were limited. Binomial logistic regressions indicated that assumed parental preferences were strongly associated with late adolescents’ own preferences. Conclusions Findings suggest a clear difference between late adolescents’ preferences and assumed parental preferences: they believe that their parents are less inclined to favor confidentiality and adolescent consent. We also find that this difference depends on the case, indicating that there is no such thing as general ‘confidentiality preferences’. Rather, a decision- and/or context-specific perspective should be adopted.

Clinical adolescent decision-making: parental perspectives on confidentiality and consent in Belgium and The Netherlands

“…In addition to their involvement in decision-making, privacy and confidentiality is of great importance to adolescents (De Coninck et al, 2021). Research shows that many adolescents value confidentiality during consultations and would sometimes prefer to be alone with their physician (Carlisle et al, 2006;De Coninck et al, 2021). This is especially true for girls (Carlisle et al, 2006) and is consistent with research on adults which shows that men tend to have greater faith than women in the preservation of confidentiality by healthcare professionals (Shickle et al, 2002).…”

“…In spite of the view that shared decision-making provides the most advantageous decision-making dynamic for all parties involved (Lipstein et al, 2012;Park & Cho, 2018), physicians regularly have to cope with conflict situations between parents and their adolescent children regarding medical treatments or information (Song et al, 2019). In addition to their involvement in decision-making, privacy and confidentiality is of great importance to adolescents (De Coninck et al, 2021). Research shows that many adolescents value confidentiality during consultations and would sometimes prefer to be alone with their physician (Carlisle et al, 2006;De Coninck et al, 2021).…”

“…For example, they are aware that more intimate health issues are more easily discussed during a private consultation with a trusted physician, without parents present (Duncan et al, 2011). Despite the complex family-and health-related situations that may arise from these tensions and the mismatch in terms of perceptions between parents and adolescents (De Coninck et al, 2021), relatively little research has been conducted on these perceptions and opinions. Family scholars and medical experts argue that adolescents' decisionsif they are considered competent by a physicianshould always be respected even though these adolescents may be legally too young to provide consent (Berlan & Bravender, 2009;Ford et al, 2004).…”

“…Parental attitudes regarding confidentiality and consent are likely to have an impact on medical decision-making among adolescents: adolescents who believe their parents disapprove of or insist on knowing what is discussed with healthcare providers have higher odds of delaying or foregoing healthcare, which may have adverse short-or long-term health repercussions (Thrall et al, 2000). Despite this, parental attitudes regarding these confidentiality and consent in medical decision-making have received limited attention in the literature (De Coninck et al, 2021). While shared decision-making is considered to be the ideal model in pediatric decision-making, most studies focus on the role of the physician or adolescent (Lipstein et al, 2012).…”

Health-related confidentiality and consent among minors: Data on adult perspectives from Belgium and The Netherlands

“…With these data, we provide new insights into the preferences of adults regarding 12 different hypothetical cases. The need for new insights in this topic is great as survey data are rare, despite the growing diversity of family types in recent years [ 1 , 2 ]. Through this online survey, we collected quantitative data on preferences regarding health-related confidentiality and consent for minors, family communication, relationship quality, and sociodemographic characteristics for the adult population aged 35 to 55 in Belgium and The Netherlands.…”