Consenting, competence and confidentiality in paediatric adolescent gynaecology

Key content Clinicians can often face dilemmas in the care of adolescents owing to the lack of understanding over the legal rights and ethical responsibilities involved in their care. A clinician looking after an adolescent should have a good understanding of the principles of adolescent consenting. Often it is necessary to involve the multidisciplinary team and, in extreme circumstances, the court when there is a dispute regarding the competence of the adolescent to consent. Every unit should ensure that they have guidelines for paediatric adolescent gynaecology (PAG) consenting. Areas requiring specific consideration in PAG consent are discussed in this article. Learning objectives To understand the issues and ethical dilemmas a clinician can face in PAG consent. To understand the current guidance and principles. To develop a problem-based approach to sharing information with adolescents. Ethical issues Healthcare professionals must balance the duty of confidentiality with the duties of safeguarding. There can be challenges in influencing the parental authority over the adolescent and balancing this with the child's best interest. Care must be taken in judging the capacity of the adolescent to make decisions.