Parental Perspectives on Adolescent Health-Related Confidentiality: Trust, Responsibility, and Disease Etiology as Key Themes



      As children progress through adolescence, they become more independent and more responsible regarding their health. This shift in responsibility from the parents to the adolescent poses a challenge for healthcare professionals who must consider both parties. Pediatricians and other healthcare professionals may encounter problems regarding consent and confidentiality. This study aimed to investigate the opinions of Belgian parents of adolescents concerning cases about confidentiality in adolescent health problems.


      A qualitative methodology with semi-structured interviews and a case-based approach was chosen to answer our study aim. Belgian parents of adolescents were recruited voluntarily; 20 parents were interviewed. Parents’ opinions on four different cases regarding confidentiality were obtained. Interviews were audio- and video-recorded and transcribed verbatim. Independent coding of the transcripts was conducted.


      Parents’ opinions differ considerably when asked if a physician has to maintain confidentiality toward the adolescent, depending on the content of the case. Opinions appear underpinned by three factors: trust, responsibility of the different parties, and the etiology of the problem.


      This study shows that the nature, severity, and frequency of the medical issue at hand shape the opinions of parents toward patient confidentiality, on top of the trust and responsibility factors also highlighted in previous work. This is in contrast to the Belgian legislation, which focuses on maturity regardless of context.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Adolescent Health
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Ford C.A.
        • English A.
        • Dowshen N.
        • et al.
        Confidentiality in adolescent health care.
        Health Promotion Child Adolescents. 2016; 135: 347-370
        • Ford C.A.
        • English A.
        • Sigman G.
        Confidential health care for adolescents: Position paper of the Society for adolescent medicine.
        J Adolesc Health. 2004; 35: 160-167
        • Sanci L.A.
        • Sawyer S.M.
        • Haller D.M.
        • et al.
        Confidential health care for adolescents: Reconciling clinical evidence with family values.
        Med J Aust. 2005; 183: 410-414
        • Ferguson L.
        The end of an age: Beyond age restrictions for minors’ medical treatment decisions. SSRN Electron J.
        (Available at:)
      1. Patient’s rights.
        • Berlan E.D.
        • Bravender T.
        Confidentiality, consent, and caring for the adolescent patient.
        Curr Opin Pediatr. 2009; 21: 450-456
        • De Coninck D.
        • Matthijs K.
        • de Winter P.
        • Toelen J.
        Late adolescents’ own and assumed parental preferences towards health-care related confidentiality and consent in Belgium.
        Plos One. 2021; 16: e0252618
        • Chulani V.L.
        • Gordon L.P.
        Adolescent growth and development.
        Prim Care - Clin Off Pract. 2014; 41: 465-487
        • Duncan R.E.
        • Vandeleur M.
        • Derks
        • et al.
        Confidentiality with adolescents in the medical setting: What do parents think?.
        J Adolesc Health. 2011; 49: 428-430
        • Song X.
        • Klein J.D.
        • Yan H.
        • et al.
        Parent and adolescent attitudes towards preventive care and confidentiality.
        J Adolesc Health. 2019; 64: 235-241
        • Agostino H.
        Provision of adolescent confidential care in a Tertiary care setting.
        Paediatrics Child Health. 2021; 26: e101-e102
        • Klein J.D.
        • Mcnulty M.
        • Flatau C.N.
        • et al.
        Adolescents’ Access to Care. 1998; 152: 676-682
        • Michaud P.A.
        • Berg-Kelly K.
        • Macfarlane A.
        • et al.
        Ethics and adolescent care: An international perspective.
        Curr Opin Pediatr. 2010; 22: 418-422
        • Sasse R.A.
        • Aroni R.A.
        • Sawyer S.M.
        • et al.
        Confidential consultations with adolescents: An exploration of Australian parents’ perspectives.
        J Adolesc Health. 2013; 52: 786-791
        • Stavleu D.C.
        • de Winter P.J.
        • Veenstra X.
        • et al.
        Parental opinions on medical decision-Making in adolescence: A case-based Survey.
        J Developmental Behav Pediatr. 2022; 43: 17-22
        • Tebb K.
        • Hernandez L.K.
        • Shafer M.A.
        • et al.
        Understanding the attitudes of Latino parents toward confidential health services for teens.
        J Adolesc Health. 2012; 50: 572-577
        • McKee M.D.
        • O’Sullivan L.F.
        • Weber C.M.
        Perspectives on confidential care for adolescent girls.
        Ann Fam Med. 2006; 4: 519-526
        • Lyren A.
        • Kodish E.
        • Lazebnik R.
        • et al.
        Understanding confidentiality: Perspectives of African American adolescents and their parents.
        J Adolesc Health. 2006; 39: 261-265
        • Jackson M.K.
        • Burns K.K.
        • Richter M.S.
        Confidentiality and treatment decisions of minor clients: A health professional’s dilemma & policy makers challenge.
        SpringerPlus. 2014; 3: 1-8
        • Vanwymelbeke J.
        • De Coninck D.
        • Matthijs K.
        • et al.
        Clinical adolescent decision-making: Parental perspectives on confidentiality and consent in Belgium and The Netherlands.
        Ethics Behav. 2022; (Online early)
        • Gill P.
        • Baillie J.
        Interviews and focus groups in qualitative research: An update for the digital age.
        Br Dental J. 2018; 225: 668-672
        • Dierckx de Casterle B.
        • Gastmans C.
        • Bryon E.
        • Denier Y.
        Quagol: A guide for qualitative data analysis.
        Int J Nurs Stud. 2012; 49: 360-371
        • Corbin J.
        • Strauss A.
        Basics of qualitative research: Techniques and procedures for developing grounded theory.
        4th edition. Sage, London, UK2014
        • Pontes A.
        • Henn M.
        • Griffiths M.D.
        Towards a conceptualization of young people’s political engagement: A qualitative focus group study.
        Societies. 2018; 8
        • Grilo S.A.
        • Catallozzi M.
        • Santelli J.S.
        • et al.
        Confidentiality discussions and private time with a health-care provider for youth, United States, 2016.
        J Adolesc Health. 2019; 64: 311-318
        • Thrall J.S.
        • McCloskey L.
        • Ettner S.L.
        • et al.
        Confidentiality and adolescents’ use of providers for health information and for pelvic examinations.
        Arch Pediatr Adolesc Med. 2000; 154: 885-892
        • Mynttinen M.
        • Pietilä A.M.
        • Kangasniemi M.
        Parents’ perspective on their responsibilities with regard to adolescents’ use of alcohol.
        Scand J Caring Sci. 2020; 34: 919-928