School-Based Youth Health Nurses and Adolescent Decision-Making Concerning Reproductive and Sexual Health Advice: How Can the Law Guide Healthcare Practitioners in this Context?

Abstract

Abstract School-Based Youth Health Nurses (SBYHNs) work in Queensland high schools, providing sexual and reproductive health care/advice (amongst other things) to adolescents. SBYHNs are often responsible for referring high school students to other health care practitioners or external health services/community agencies. One of the difficulties faced in this context is how to assess the issue of capacity in terms of the adolescent's ability to provide consent to his or her own health care without parental involvement. This is important because it enables SBYHNs to maintain confidentiality with adolescents, which encourages adolescents to obtain sexual health advice. In this paper we outline the key legal principles relevant to nurses working in this field. We provide some practical examples of issues faced by SBYHNs and consider how the issue of Gillick competency is relevant to these examples. We demonstrate that the law seeks to prioritise the concept of confidentiality and aims to avoid exposing adolescents to harm that may result from unsafe sexual practices. Importantly, the issues discussed in this paper are relevant to nurses working within this field in all Australian jurisdictions.