Do doctors betray the trust of adolescents? | KM.RU

Passing on sensitive information about adolescent health to parents by doctors will widen the generation gap


© KM.RU, Alexandra Vozdvizhenskaya

The State Duma will consider a bill on the abolition of medical secrecy for children aged 15 to 18 years. If it is accepted, doctors, without the consent of adolescents, will be able to inform parents about their state of health, including, for example, violation of virginity, sexually transmitted diseases, certain addictions, etc.

The bill was another attempt to control Russian youth and infringement of their rights. Rosbalt asked experts to comment on possible risks in the implementation of these initiatives.

Lev Scheglov, sex therapist and psychotherapist, doctor of medical sciences:

“The proposed bill is a demonstrative disrespect for our young citizens. The age of consent, that is, the age when a boy or a girl, as it were, “has the right” to have sex, is lower. This means that the right of a young person to decide is recognized here. And in this bill it turns out that a person under 18 is not only not a teenager, not a boy or a girl, but in general, in fact, a child.

I don’t really understand what triggered such an initiative. Although in the general context we have seen in recent years: whatever the initiative of the bill, then some kind of obscurantist nonsense.

Such a law could still be completely “vegetarian” if one presupposes an atmosphere of complete trust and complete openness between parents and their children. But practice shows that this is a rather rare type of relationship.

Unfortunately, often young men, and most often girls, are simply afraid of their parents. This pushes them both to hide information, and to early marriages – just to slip out from under the tireless eye of their parents.

Such a law, if passed, will only exacerbate this situation. But we must understand that in our Duma there are very strange, extremely strange people, from the point of view of psychology and psychiatry. “

Alina Chimbireva, lawyer, head of Melegal:

“Restricting medical secrets and ensuring access of legal representatives to medical secrets of minors, ie to information about the facts of a minor’s appeal for medical care, about his state of health, will lead to a decrease in the level of confidence of minors in medical care.

This is a very important factor – providing assistance provided that it is impossible to disclose information. We now have the 323rd Federal Law, which regulates the issues of medical confidentiality and gives an exhaustive list of cases when its disclosure is possible without the consent of the patient.

In my opinion, the expansion of this list towards, roughly speaking, the right of the legal representative of a minor to freely receive information about his health is not justified.

The law establishes the age – 15 years – from which a minor gives voluntary informed consent to medical intervention on his own.

An attempt to present the introduced bill as a prerequisite for the responsibility of a legal representative for the life and health of a minor is untenable. Law 323 is aimed at regulating health care. As regards the right of a minor to medical confidentiality, in my opinion, its wording is optimal.

For example, the facts of adolescents seeking medical assistance in connection with issues of sexual activity. There has already been an attempt at the regional level, in the Saratov region, to introduce the obligation to report the facts of deprivation of virginity or teenage pregnancy. This attempt was canceled two weeks later.

Teenagers who apply for some intimate issues and do not want publicity – if changes are made, if there is a practice of disclosing information to legal representatives without their consent – they will stop contacting doctors and will look for some alternative ways to resolve health problems.

This will lead to both demographic and adolescent health problems.

Moreover, minors have the right to privacy and inviolability. The argument that adolescents underestimate the complexity of diseases and the like seems to be untenable.

Again, the doctor informs the minor in an accessible form about the diagnosis, the course of the disease, the need for and the method of its treatment. The situation of disclosing medical confidentiality, as well as providing medical assistance in the absence of a person’s consent, has already been regulated by law.

I think this is obvious: if a teenager wanted the parent to know about the fact of treatment or the state of health, he would come to the hospital with him, or talk about his problems at home. Cases when a teenager arrives without a parent already usually implies that he wants confidentiality. “

Iskander Yasaveev, Doctor of Sociology, Senior Research Fellow, Center for Mathematical Studies, National Research University Higher School of Economics:

“We see a clear manifestation of the power of adults over youth that exists in Russian society. This power permeates all youth-related relationships – employment and job placement, life chances, and so on – but it also applies to negatively labeling youth.

This is a common manifestation of the traditionalism that now dominates. In the history of societies, periods of traditionalism are replaced by anti-traditionalism. Now we live in the era of traditionalism, when very many people, for example, State Duma deputies, think that they know “how best”, that there are recipes that have been tested by time.

Such a phenomenon has always been observed, this is a kind of generational conflict, and therefore it is not surprising that the older generation tries to impose on the younger some patterns of behavior that seem preferable to him. But now in Russian society the natural direction of development is taking on some extreme forms.

However, this approach is completely ineffective, it just doesn’t work. A significant part of young people ignore, do not notice the instructions and wishes of the traditionalists.

Obviously, this will lead to unpredictable consequences: and it already does – in the form of youth resistance to labeling and total control.

It is pointless to control young people, since they do not obey such schemes, find options for violating norms, and fencing off the space of freedom for themselves. This caravan is on its way, and young people live in a completely different reality, in a different space. “

Boris Kagarlitsky, Director of the Institute of Globalization and Social Movements, Ph.D. in Political Science:

“Our deputies and high-ranking officials in general – but first of all, of course, the Duma members – in principle, have only one instrument of influencing the situation: this is a ban. If there is a problem or something worries them, they immediately think what and how to prohibit.

I think that this is what their whole activity comes down to: it is coming up with new and new prohibitions. And so it turns out – purely technically – that the younger generation is more often than others the victim of prohibitions. The fact is that the Duma deputies are fighting not so much against young people as against reality in general. And this war takes on absurd forms.

Of course, they proceed from the traditionalist ideology, but this is because they were simply told that they should proceed from it. If tomorrow they are told to preach gay marriage, I assure you that all these people will preach gay marriage with the same zeal, and maybe even with even greater zeal.

Moreover, if they are ordered to become gay, they will all become gay. So it’s just a matter of installation. “

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