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Abstract
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Adolescent relationship abuse (ARA) occurs in a wide range of interactions among adolescents. Most young people victimized by ARA would benefit from the support of a trusted adult. The disclosure of ARA victimization presents important clinical and legal questions as well as ethical dilemmas. Healthcare providers caring for adolescents are increasingly likely to confront these questions as awareness of ARA increases and in light of the widespread prevalence of ARA.
A recent study by Jennifer Wiebelhaus et al. explored the perspectives of adolescents and parents about parental notification after an adolescent discloses ARA to a healthcare provider. The types of abuse in their study were physical, cyber, psychological, and sexual ARA; reproductive coercion; controlling behavior; and feeling unsafe. As Wiebelhaus et al. explain, ARA is multifaceted and complex. It includes some behaviors that are criminal, others that are legally considered child abuse, and many that are associated with serious short- and long-term adverse physical and psychological outcomes . For this reason, along with appropriate health care, adult support may be needed by a young person experiencing ARA.
A healthcare provider treating an adolescent who discloses ARA must address not only the immediate concern of what health care is needed but also a range of legal and ethical questions: Is the adolescent willing to disclose the ARA to a parent or other trusted adult? Does the adolescent insist that confidentiality protection is essential? Is the adolescent in continuing danger? Is the ARA experienced by the adolescent reportable as child abuse? Do legal requirements and ethical principles require, permit, or preclude disclosure? Are there ways that the ARA may be inadvertently disclosed? These questions require understanding the importance of confidentiality in adolescent health care, the significance of child abuse reporting and other disclosure mechanisms, the role of parents and other trusted adults, and evolving confidentiality challenges....
Language: en |