Study of Knowledge, Attitude and Practice Regarding Adolescent’s Rights to Autonomy and Confidentiality among Physicians Working in Ain Shams University Hospitals

Abstract

Abstract Background Legally, adolescents are not capable of making medical decisions and considered incompetent because of their age. However, psychological studies found adolescents are capable of making informed choices about involvement in health care and research. Aim This study aimed at assessment of physicians knowledge, attitude and practice regarding sharing of adolescents in medical decision making and their right in confidentiality. Methods An online self -administered structured questionnaire was used for 384 physicians working at Ain Shams University Hospitals during the period from December 2019 to December 2020. Results Most of the participants were knowledgeable of variable ages of legal consent between countries (54.7%) while 46.97% of them know the legal age for consent in Egypt. Most of them were aware that they should obtain consent from the adolescents before their involvement in clinical research (87.7%); their duty to breach the confidentiality of the patient’s medical information if this is necessary to protect him/ her or the surrounding people (85.4%). About 45% of them agreed with the adolescent’s ability to make a sound decision regarding his/her health and 47.1% of them were neutral with the adolescent’s right to refuse the proposed treatment even if this against parents’ decision. Most of them agreed with the adolescent’s right to confidentiality if there is no risk for the patient or the surrounding persons (64.3%). Almost all of them obtain consent from both the adolescent patients and their parents/guardians (either always (69.8%) or sometimes (26.3%,)); and give the adolescent an opportunity to speak in private (either always (43.5%) or sometimes (55.2%)). Conclusion Although of the participants’ positive attitude toward sharing the adolescent patient in medical decisions- making, and their right to confidentiality, their practice showed variable responses. This may be due to deficient knowledge of the laws and absence of definite ethical guidelines for health care of adolescent patients. Recommendation Training of the physicians on judgment and assessment of adolescent patient’s capacity is an important step to ensure their involvement in decision making. Also, it is important to formulate ethical guidelines for management of adolescent patients in our community.