Health independence for teenagers
At the beginning of adolescence, you’ll usually be fully responsible for your child’s health care. As your child matures, they need to develop skills and knowledge to manage their own health.
At the same time, health professionals will start taking into account your child’s ability to make independent health decisions. Also, the law recognises that teenagers become more able to make health decisions as they move towards adulthood.
This is called health independence.
Your child will need your support and guidance plus practice to develop health independence. For example, you’ll need to help your child learn to do things like:
- giving informed medical consent
- speaking confidentially to health professionals
- interacting with health services
- managing their own health information
- raising health care concerns
- managing Medicare enrolment.
The balance between your responsibility for your child’s health and their health independence will change as your child gets older. Together, you and your child can work out when and how to adjust the balance. But as a guide, the support your child needs at 12-14 years will be different from what they need when they’re 15-17 years or 18-19 years.
While your child is still in early adolescence, it’s good for them to see the GP alone for at least part of a consultation. This is a safe and positive way for them to start developing health independence.
Consent to health care treatment: rights
In Australia, parents and teenagers both have rights to consent to a teenage child’s treatment.
Your child’s rights at 14-16 years
At around 14 years, young people can consent to simple health care treatments without involving parents or guardians. This means your child can start making decisions by themselves and for themselves if health professionals believe your child can understand:
- the health problem
- the consequences of treatment choices
- any potential risks from procedures or interventions.
Your child’s rights from 16 years
From the age of 16 years, your child can consent to medical and dental treatment with the same authority as an adult. But your child doesn’t have an automatic right to refuse medical treatment, particularly life-saving treatment.
Your rights as a parent
As a parent, you have rights in relation to your child’s treatment. Parents or health professionals can mount a legal challenge if a teenage child has refused medical treatment in life-threatening circumstances.
If the legal position of consent isn’t clear or there’s a dispute about treatment, a court can decide based on the best interests of the child.
Health professionals will encourage your child to talk to you. You’ll always be contacted if a health professional thinks your child isn’t mature enough to consent to their own treatment.
In most cases, when your child is 18 years old they’re considered to have full legal capacity to give consent to and refuse medical treatment. If your child can’t make health care decisions, they can have a medical treatment decision maker. This might happen if your child has an intellectual or developmental disability.
Confidentiality in health care: rights
Confidentiality is your child’s right and a legal requirement for doctors and other health professionals.
Confidentiality means keeping health and personal information private and safe. Health information includes things that people and health professionals talk about, notes that professionals take, and treatment details.
In most situations, doctors and other health professionals can’t tell anybody else – including you – what your child tells them during a consultation, unless your child has given them permission. They also can’t tell you the results of any tests your child has. Sometimes health professionals ask patients to sign a consent form before they contact or talk with family or other professionals.
Confidentiality may be broken in some circumstances. For example, health professionals may break your child’s confidentiality if they believe that your child is:
- at risk of self-harm or suicide
- being seriously harmed or at risk of being seriously harmed
- seriously harming someone else or at risk of seriously harming someone else.
Confidentiality may also be broken for legal reasons like a court subpoena or other statutory requirements like child protection. This would happen only in very serious cases.
Where possible, health professionals will talk with your child about breaking confidentiality beforehand. They’ll explain what they’ll share, who they’ll tell and why.
Confidentiality is one of the biggest concerns for teenagers. Confidentiality and private time with health professionals can build trust and help teenagers open up about personal issues. But if teenagers feel that confidentiality might be broken, it can stop them from seeking support. You can encourage your child to seek health support by respecting their right to privacy and confidentiality.
Responsibilities in teenage health care
Your child can take responsibility for their own health care by:
- having appointments on their own
- answering questions and giving information about their health in an open and honest way
- letting health professionals know about changes in their health or circumstances that might put their health care at risk
- letting health professionals know if they decide to change or stop treatment
- respecting health care staff and other people using services, and thinking about other people’s rights and needs
- taking an active part in their health care decisions and asking questions if they’re not sure about what’s happening to them
- speaking up when they’re not happy about the care they’re getting so that issues can be dealt with quickly and fairly
- asking for support with any aspect of their health care.
Teenage health records and information
All health professionals keep records of appointments. These records are kept confidentially, and there are laws and guidelines about how they’re shared.
Your child’s My Health Record
Australia has a national electronic My Health Record system. This is a secure, personally controlled online summary of a person’s health information.
From the age of 14 your child can control what goes into this record and who has access to it. This record allows your child and health professionals to view and share your child’s health information.
Sharing your child’s health information
So your child can get the best possible health care, health professionals might need to share information with treatment team members.
Health professionals share information only when it benefits your child’s treatment and care. Professionals will usually ask for your child’s permission to share information. If there are things your child doesn’t want shared, encourage your child to tell health professionals.
In public hospitals relevant health information can be shared among treating health professionals (without formal consent) when it helps patient care – for example, test results and information about treatments or therapies.
Public hospitals also usually pass on relevant information about treatment to the patient’s GP – for example, information about visits to emergency departments or hospital admissions.
Health professionals will share information when your child moves from one service to another – for example, when your child moves from child to adult health services. This will often be a detailed summary or referral letter with copies of recent and relevant diagnostic tests or results.
Your child needs to give permission for health information to be shared between public and private services or between private health professionals.
How teenagers can raise health care concerns
If your child has concerns about privacy, confidentiality, type of treatment, length of treatment or the way they’re being treated, it’s best if your child raises them with the health professional at the time.
If this doesn’t sort out your child’s concern, they can raise the concern with the Australian Health Practitioner Regulation Agency (AHPRA). AHPRA manages the governing boards of many health professions.
Your child can also contact the Australian Healthcare Complaints Commissioner for your state or territory. This agency can look into complaints about medical and health care.
Teenagers and Medicare
Medicare is Australia’s universal health care scheme, funded by the Australian Government. It gives all Australian citizens, permanent residents and some visa holders access to a wide range of health services at little or no cost. It doesn’t cover the cost of an ambulance.
You need a Medicare card to get Medicare benefits. Your child can get their own Medicare card when they’re 15, or younger if you ask for it. Your child can also choose to stay on your family Medicare card and have a copy made to keep with them.
Bulk billing is when Medicare pays the whole cost of seeing a health professional, but not all health professionals and services use bulk billing. If your child is making their own medical appointments, remind your child to ask whether the service or professional bulk bills. If they don’t, your child can ask whether they can get a Medicare rebate.
A Medicare rebate is when you pay a fee to see a health professional and then get part of the fee or the whole fee back from Medicare. Many GPs and specialists give you Medicare rebates when you see them, providing you’re registered with Medicare.
There’s often a gap between what health professionals charge and what Medicare pays. This is called a gap fee and varies depending on what the health professional charges.
If you or your child have an eligible concession card, you can use it to pay less for health services and prescription medicines.