This should form a conclusion which should prove or disprove the hypothesis. DISCUSSION Confidentiality Is a very complex issue especially with adolescents and there appears to be no clear guidelines for Health Care Professionals to follow. The NC code of conduct (2008) stipulates that people’s right to confidentiality must be respected which therefore suggests that this applies to both adults and children. Bernard and Chapman (2003) recognize the necessity of confidentiality and stipulate that this should be honored to adhere to the NC Code of conduct.

It is a concept which is based on the Hippocratic Oath which states that anything heard in secret should be kept silent. One of the important factors of confidentiality that is highlighted is trust. It is believed by Bernard and Chapman that without this a therapeutic relationship cannot be developed. Gland (1996) also made this observation in her study of teenagers accessing sexual health advice where trust was deemed to one of the most important part of the service. TLS Is data that has been collected qualitatively from young people that have accessed the service.

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The article doesn’t highlight how many participants took part In the study so this does question Its reliability. Winterer and Priestley (2006) found that infallibility was the most important factor for young people who attended the sexual health clinic. According to Thomas et a (2005) 54% of teenagers would not attend the clinic if their confidentiality was not going to be kept. This is more than half of all teenagers asked within this quantitative piece of research. Unfortunately it does not highlight how many children took part in the survey. This is further backed up by Larches (2005) where he observes that teenagers rate confidentiality as one of the most vital characteristics of the care they receive. This is believed to be plopped from mutual trust between the parties. However, there appears to be no research to back up Larches ideas which could question the reliability of the article although this observation has been made by many people which would suggest It Is conclusive.

Interestingly trust was apparent wealth the critical Incident and Sarah incidents of mistrust. Michael and Tingle (2007) depict confidentiality as being a Temperamental part AT nursling Witt gleefulness Tanat are Decoding progressively more difficult to define. It is suggested that children present more complex issues with guards to their rights especially within adolescence. This is because cognitive maturity onsets at different times. This dilemma was addressed in Killing v.

West Norfolk and Wishes AHA (1985) where a child under the age of sixteen was given contraceptive advice without her parents being informed. In this case the child was deemed to be competent to make their own decision thus the term ‘Killing competent’ arose (Diamond 2003 and 2005). This is now an approach that is followed in relation to confidentiality (Montgomery 1987, Grub and Pearl 1986). Children are entitled to confidentiality within a health care issue. There should be no reason why confidentiality needs for a child should differ from that of an adult needs.

However, for older children wishing to keep information from their parents then the circumstances of the issue has to be considered to assess if a duty of confidence applies as well as Judging if there are any Justifications for the confidence to be breached. This would be if the child is considered to be at risk from harming themselves or others or if there are any safe guarding children issues. (Montgomery 2003). The Data Protection Act (1998) was implemented primarily to protect influential data being shared as well as giving people fundamental rights; in particular it gave people the rights of privacy.

This is in combination with article 8 of the Human Rights Act (1998) which recognizes an individual’s right to privacy. It stipulates that no intervention will be initiated to interfere with individuals rights unless it is necessary by law to do so. Complexity arises when trying to make sense of the duty of confidentiality. It is not always clear when breaking confidentiality is allowable. There are circumstances when by law it has to be broken this would be he case of the child was considered to be at risk from harm. This is also included in the NC code of conduct (2008) which states information should be disclosed if there is risk of harm.

These principles are determined in the majority by case law. Judgments of when confidentiality may need to be broken should be made by a Health Professional with a duty of confidentiality. They will be personally and professionally accountable for the decision they make (Diamond 20003, Patterson 2006). In this case the School Nurse made a professional Judgment that Sarah was competent to have her confidentiality maintained. Competence is not simply a characteristic that you automatically have or do not have. It is dependent on the trust between the Health Care Professional as well as the child and their family.

It is developed from involving children in their health care decisions. This is by ensuring they can comprehend and retain any information that is given to them and weigh up the pros and con’s to make informed decisions about their health care (Patterson 2006, Department of Health 2001). A competent child is entitled to have their treatment confidential unless there are Justifiable reasons for this to be broken Department of Health 2001). Autonomy is the concept of self-government. It was previously thought that children and autonomy were concepts that did not exist exclusively.

However, it is now thought that children can make their own decisions about the health care they receive if they are given information that they can understand (Alderman 2000, Glasses and Richardson 2006). The Royal College of Psychiatrists (2005) produced a leaflet aimed at teenagers with eating disorders. It is an easy to read leant wanly tells young people auto ten control In an understandable way. It tells readers that if they do not want their parents to know then they do not have to be told as young people are entitled to their confidentiality.

It does state that in the event of abuse or stress in the family then this confidence will be broken. There does not appear to be any research within the leaflet which leads us to an inconclusive conclusion as to how reliability of the information enclosed. However, the National Institute for Clinical Excellence (2004) produced a reference guide backing up their information guide. The NICE guidelines state that adolescents with an eating disorder should have their right of confidentiality respected. These guidelines are high quality documents that use evidence based practice to develop their ideas.

They are written by an advisory group of health care professionals, people working in the INS, patients, career and the public thus making this qualitative data. To be a reliable piece of qualitative data it should fulfill four types of criteria. These are credibility, dependability, configurability and transferability. It could be thought that this work is credible as it involves a range of efferent people brought together in a group to discuss certain pieces of guidance in a methodical way and is developed using he expertise of the National Health Service (INS).

These guidelines are audited periodically which would suggest they are dependable. The research appears to be conformable as the data is collected from a combination of different people to get conflicting opinions this also fulfils the criteria of transferability (Polity and Beck 2006). It doesn’t specify within the booklet how many people took part in the research so this may affects its reliability although it does life the criteria of being a trustworthy piece of work.

One of the issues that has become apparent during the analysis is that many Health Care Professionals are unsure whether their young patient is entitled to confidentiality or not. Bartholomew et al (2007) carried out a quantitative piece of research to determine how a General Practitioner would proceed when presented with the scenario of a young person with an eating disorder. A thousand questionnaires were sent out of which 305 were returned. It indicated that 62% of GASP would find the young person to be competent, here’s 82% of the GASP would have maintained the young person’s confidentiality.

Further analysis revealed a huge inconsistency with understanding of the legalities of confidentiality for young people. Interestingly a higher amount of doctors would have maintained the child’s confidentiality even though they deemed them to not have sufficient maturity and understanding to be deemed competent. This highlighted issue clearly needs improving so that people are educated on the rights for their patients. An easy to read leant wanly tells young people auto ten contralto In an