Understanding Parental Access to Minors’ Confidential Health Records in NC (2009)

Undergraduate: Lauren Slive

Faculty Advisor: Christine Durrance
Department: Public Policy

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Adolescent access to confidential health care is a pertinent aspect of public health in North Carolina and the greater United States. In North Carolina, minors are able to obtain specific sexual and mental health services confidentially. However, NC General Statue 90-21.4(b) allows physicians to inform parents about such confidential services, against the will of the patient, if the physician feels that disclosure is “essential to life or health” of the minor. The purpose of this study is to explore how physicians define “essential to life or health,” and thus determine protocol for releasing minors’ records of confidential services to parents. Thirteen qualitative interviews of adolescent health expert and non-expert physicians in North Carolina were performed. Responses to questions and analyses of hypothetical scenarios reveal that experts were less likely to make a decisive decision about disclosure initially. Non-experts were more likely to make decisive decisions about disclosure, and less likely to discuss confidentiality with patients before providing care. Policy recommendations include providing physicians with information about confidentiality policies, encouraging discussions with patients, and ensuring changes in health care delivery, such as electronic records, are structured to promote confidentiality. Finally, policymakers must consider the specific needs of minors that influence access to care, such as proximity to clinics and availability of transportation.