Which statement best describes a common confidentiality exception for adolescent health care?

• A. All information is confidential
• B. Disclosure only with parental consent
• C. Safety concerns requiring disclosure
• D. Confidentiality never overrides privacy

Answer: (C)

When caring for adolescents, confidentiality is essential to encourage honest disclosure, but it is not absolute. The most common exception is safety concerns that require disclosure. If there is a real risk that the adolescent could harm themselves or others, or if there is abuse or neglect, health professionals are ethically and often legally obligated to break confidentiality to protect the patient or others. The disclosure should be limited to what is necessary and guided by applicable laws and reporting requirements.

This means that while most information stays confidential, imminent danger creates a legitimate exception where sharing information with the appropriate people (and sometimes authorities) is warranted to prevent harm. For example, if a teen expresses a plan to commit suicide or to harm someone, or if abuse is suspected, the clinician would take steps to ensure safety, which may involve informing a parent or guardian or other authorities, depending on the jurisdiction and the situation. In contrast, blanket statements like all information being confidential or confidentiality never overriding privacy ignore these important safety safeguards and are not accurate. Similarly, stating that disclosure requires parental consent for all matters ignores the many situations where minors can consent to certain services themselves and where safety concerns supersede the need for parental consent.