Treatment of unaccompanied minors in primary care clinics - caregivers' practice and knowledge

Research output: Contribution to journalArticlepeer-review

Abstract

Background: By law, the provision of medical treatment to minors in the State of Israel is conditional upon the consent of their parents. In 2004, the Head of the Medical Administration Unit in the Ministry of Health issued Circular No. 4/2004 regarding the treatment of un-accompanied minors in primary care clinics. This circular aims to expand on the law, and permits the treatment of certain minors without parental attendance or consent. The circular does indicate that parents should be notified of the treatment retroactively, and provides cases in which it is possible to avoid notification altogether. The objectives of this study were: (a) to examine the scope of treatment of unaccompanied minors in primary care clinics; (b) to examine caregivers' knowledge of the provisions of the law and of the circular; and (c) to examine the implementation of the law's and the circular's provisions relating to the treatment of unaccompanied minors in primary care clinics in the community. Methods: In a cross-sectional study, we surveyed 158 doctors and nurses from primary care clinics of the Haifa and Galilee districts of "Clalit Health Services". Respondents were selected via a snowball method, with attention to ensuring a heterogeneous clientele and geographic dispersion. Results: Treatment seeking by unaccompanied minors is an existing and even widespread phenomenon. The vast majority of unaccompanied minors were in effect treated without parental consent. The main reason for minors' solitary treatment seeking was parents being busy. In 40% of the cases, where minors were treated without the presence and consent of their parents - parents were not notified of the fact. None of the respondents correctly answered all questions regarding the relevant provisions of the law and circular, and only 10% answered all the questions regarding the circular's parental notification requirements. Conclusions: The Israeli legal arrangement, pertaining to the provision of treatment to minors without the consent of their parents, is vague, unclear to medical and nursing practitioners and limited in terms of the needs of the minors themselves, as well as the needs of the medical system. There is a need for methodical and coherent regulatory thinking on the subject, as well as more thorough education of both nurses and physicians, in order to ensure the rights and interests of minors as well as the rights of their parents.

Original languageEnglish
Article number29
JournalIsrael Journal of Health Policy Research
Volume7
Issue number1
DOIs
StatePublished - 1 Jun 2018

Bibliographical note

Funding Information:
In light of incomplete attempts to more comprehensibly regulate the treatment of minors and their consent to treatment, the Ministry of Health attempted to define rules of thumb that will help practitioners deal with the dissonance between regulation and the needs of their minor patients. Thus, in 2004, the Head of the Medical Administration Unit of the Ministry of Health issued Circular No. 4/2004 concerning “visits of minors to primary care clinic without the presence of their parents” (herein – the circular) [15]. The circular aims to expand on the law, and permit the treatment of certain minors without parental attendance or consent.

Publisher Copyright:
© 2018 The Author(s).

Keywords

  • Best interests of the minor
  • Children's rights
  • Consent to treatment
  • Parental notification

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

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