Costs and confidentiality

In most situations, whatever your or son or daughter says to a doctor, counsellor, youth worker or teacher will be kept confidential. They have an ethical responsibility not to share this information with anyone else.
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However, there are some situations in which professionals are legally obliged to report information, like if they have serious concerns about a patient/client’s safety, or the safety of someone else.

It’s good to be aware of what they can and can’t keep confidential so you know what to expect.

Reporting

You might also want to find out who they have to report the situation to – it could be the Department of Children if they are worried about your child’s safety or welfare in some way. In very specific situations it could involve speaking in court or to the Gardaí.

How important is confidentiality?

It can be difficult for young people to talk about personal things, so it’s important for them to know and trust that what they say goes no further.

They should know what information can’t be kept confidential to help decide what they want to share. But you have to remember that a health professional will only pass on what you say if it’s to keep you or someone else safe. This is something you might actually need them to do, so think about it.

Does age make a difference?

Across Ireland, turning 18 years-old means a person is legally an adult and gets to make their own decisions and conversations with doctors are kept confidential. However, the law says young people aged 16 and 17 years-old also have rights to confidential care.

The exception to this is for a person of any age (whether under or over 18) who may be at risk of killing or seriously harming themselves or someone else. In this situation the health professional might need to break confidentiality in order to keep them safe.

For example, a doctor will ask themselves the following question: Is your safety at risk because of someone else?

When a doctor is obliged to break confidentiality

If your son or daughter is under 16 years-old and tells a doctor in confidence that someone they know has harmed them and it’s affecting their health, the doctor is obliged to notify proper authorities to keep them safe.

The ‘proper authority’ is a government department that is charged with caring for the welfare of children and young people. This will include things like physical abuse, sexual abuse, emotional abuse, neglect and domestic violence.

17 years-old or more

If your son/daughter is 17 or 18 years- old, the doctor can also choose to report the situation, but it is not yet mandatory.

This may be scary and it is really important that your doctor lets you know exactly what will happen and makes sure that you have plenty of adult support – from your doctor, from parents if appropriate or from others who’ll be able to help and support you.

For more information about the legal age to automatic rights to confidential health care in Ireland check out the free legal advice centres.

What about being involved in criminal activity?

Doctors are not required to report illegal drug use to the police. They are also not required to report underage sex to the police, or parents. The questions the doctor must ask when deciding if they need to report something will always be concerned with whether someone’s safety is at risk; is someone harming you, are you in danger or might someone else be?

If you are involved in a serious crime (this can include drug dealing, committing sexual assault, committing physical assault, causing grievous bodily harm and so on) and you tell your doctor, they might be required to report this. Other health professionals may have to report illegal drug use or underage sex. When you are speaking to a health professional it is a good idea to ask them what they are obliged to report.

Treatment or prescriptions without permission from parents/guardians

Young people aged 18 years-old and over are legally adults and have automatic rights to make decisions about their own health care or treatment, like going on the pill.

Exceptions to this law for young people aged 18 years-old and over are only made in the case of someone with an intellectual disability, or a mental health problem that seriously affects their ability to think clearly and make decisions about their health.

If a young person over 16 but under 18, the law can be pretty grey on the issue of consent on medical treatment. Section 23 of the Non-Fatal Offences Against the Person Act, 1997, provides that young people aged 16 years-old and over may give valid consent to medical, surgical and dental treatment. In practice it often comes down to the situation and the doctor’s perspective on whether they need a parent/guardian to be involved.

When deciding whether to treat a young person between 16 and 18 years-old, a doctor will use their judgement as to whether the person they are seeing is mature enough to be able to make important decisions about treatment on their own?

A parents’ role in support

Parents or guardians are encouraged to be a part of a young person’s mental health support.

Obviously the younger your son or daughter is, the more likely a health professional will involve you as parents or carers in some way. If it involves giving out information on an operation (including a termination of pregnancy), a doctor will more than likely insist on your consent.

Some doctors and hospitals will not give treatment (for example a minor operation) without your parents’ or guardians’ consent if the person is under 18 years-old, but it will depend on each and every situation.

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