Doctors, nurses and other health workers have a duty NOT to give out information about a client without their consent, whatever their age, except in exceptional circumstances.
A young person has the right to talk to a doctor or nurse in complete confidence about issues concerning his or her health and welfare. The only reason a medical professional can share information with another professional is if sharing that information is necessary to protect a child from harm or abuse. Even in this situation the young person should be informed of who else needs to know and why.
The same rules apply on confidentiality for under 16s. Unless disclosure is necessary to protect a young person or child from harm or abuse, any discussion with a medical professional should remain confidential.
Even if a doctor decides that a young person is not mature enough to make a decision about their treatment, the conversation should remain confidential.
Teachers and other school staff such as learning mentors will probably not be allowed to keep a discussion with a student under 16 confidential if the student discloses that they are sexually active.
Even where the teacher does not consider that the student is at risk, they are normally bound by school rules to disclose this information to the school’s nominated child protection officer. Teachers can help their students to avoid this situation by using Sex and Relationships Education and other lessons as an opportunity to clarify who can and can’t talk to them in confidence and to signpost students to a school nurse or appropriate young people’s service outside of school.
Most abortion referrals are carried out by doctors. Although some nurses are now able to refer for abortion, two doctors must still sign the notification of abortion form that is returned to the Department of Health and specifies the legal criteria under which an abortion is being carried out.
If you are supporting a woman under 16 who is seeking abortion without parental involvement or consent you need to decide whether or not you can maintain confidentiality. The referring doctor must make the final decision about the young woman’s competency and whether or not it is in her best interests to refer her for an abortion without parental consent.
Most young women choose to involve their parents or carers in their decision to end a pregnancy, and doctors will always encourage a young woman to do this. However, where there is no parental involvement it is important that another appropriate adult is there to support her, both during and after the procedure.
Although it is an offence for a man to have sex with a girl under 16 (17 in Northern Ireland) it is lawful for doctors to provide contraceptive advice and treatment without parental consent providing certain criteria are met. These criteria, known as the Fraser Guidelines, were laid down by Lord Fraser in the House of Lords' case and require the professional to be satisfied that:
the young person will understand the professional's advice;
the young person cannot be persuaded to inform their parents;
the young person is likely to begin, or to continue having, sexual intercourse with or without contraceptive treatment;
unless the young person receives contraceptive treatment, their physical or mental health, or both, are likely to suffer;
the young person's best interests require them to receive contraceptive advice or treatment with or without parental consent.
Although these criteria specifically refer to contraception, the principles are deemed to apply to other treatments, including abortion. Doctors will encourage a young person to involve a parent or carer in the decision to have an abortion because most parents are able to be supportive.
However, if the doctor agrees that it is in her best interests to have an abortion without parental involvement and believes that the young woman is competent to consent to this treatment, it is possible to refer her without consent.
A man does not have a legal right to decide whether or not his partner should continue with or end her pregnancy. He may have very strong feelings about what he would like her to do and may find it helpful to share his thoughts and feelings with you.
He might not know whether or not it is appropriate to share his feelings with his girlfriend, but it can be useful for him and for her to have an honest discussion about what they want to do. Even if they do not ultimately agree, he may find it easier to come to terms with her decision and to support her if he has had a chance to hear her thoughts about the pregnancy. Her decision too should be informed by an understanding of what he wants her to do and why.
If the young man's girlfriend chooses to go ahead with the pregnancy he might need to take financial as well as parental responsibility. Agencies like Sure Start and Connexions will be able to identify local sources of support and information for him and may help him to play a positive part in the parenting of his child in the long term even if he doesn’t remain in a relationship with his girlfriend.
If the young woman chooses to end the pregnancy, he might want to talk to his GP or an independent abortion provider such as bpas or Marie Stopes who can arrange for him to talk to a counsellor.
Any young people’s sexual health service would be happy to talk to a young man about his experience and effective ways to prevent pregnancy (and sexually transmitted infections) in the future.
For more information see men and abortion.
It is important to refer her to her GP for antenatal care as soon as possible.
Agencies like Connexions, and Maternity Alliance should be able to give her advice and help her find the practical support she needs locally. Click here to get useful information.
There should be a Teenage Pregnancy Re-integration Officer in your area, responsible for ensuring that young women are able to access education throughout their pregnancy and can be supported to return to education, training or employment in the future.
It is essential that a young woman is supported to decide what is best for her. She needs:
Nurses, sexual health workers and those working for support agencies such as Connexions may have the skills and experience to provide this kind of supportive discussion. Some young women choose to talk to someone they already know and trust rather than seek specialist help.
If it is clear that she is struggling to make a decision and does need more support than you can give her, specialist counselling is available from bpas or Marie Stopes, her GP or Brook. Click here for their contact details.
Please note: some independent agencies offer pregnancy counselling which is not non-directive and is not non-judgemental. Often this is provided by organisations that do not support the option of abortion and is designed to deter women from seeking abortion. Women have reported feeling bullied, lied to and unsupported when seeking advice from these agencies. It is essential that you are aware of the kind of service an agency provides before referring a woman there. More info.
Whatever someone’s faith or culture they will find it useful to have accurate information and a sympathetic ear. Once people have been given sound information they are able to make the best decisions they can, taking into account both their culture and their circumstances.
Make it clear that whatever information you give is the same information you give to everyone. Everyone is entitled to a full and open discussion of their pregnancy options and no one wants to feel patronised or that the professional they have come to see is making assumptions about the choice they will make.
Always bear in mind that the powerful messages about sex, pregnancy and abortion that people learn in their families, communities and from their peers are not always reflected in the choices which people from those communities make. In the UK women of all ages, ethnicities and communities access abortion services.
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