Medical secrecy for adolescents has been abolished in Russia. What does it mean?

A similar bill was introduced to the State Duma in 2018. One of the initiators of the bill, deputy Nikolai Somov

stated that due to lack of information fromparents "about problem children" there is social degradation, since "the relevant services cannot take timely measures to save teenagers."

What is medical confidentiality?

Medical secrecy is made up of information about the conditionhealth and any other information obtained during the examination (for example, about the presence of bad habits), and even the very fact of a person seeking medical help.

For disclosure of medical confidentiality depending onIn specific circumstances, a health worker may be subject to civil, administrative and even criminal liability. In the most severe cases, disclosing medical confidentiality may result in imprisonment for five years.

What changed?

Now parents will be able to receive everything on demandinformation about children’s health without their consent, including problems of an intimate and psychological nature. The authors of the bill considered that teenagers should not hide bad habits and sex life from their parents.

Concealment of information about early sexual activity incombined with the ignorance of many adolescents about methods of contraception and sexually transmitted diseases, it can lead to early pregnancy, abortion, and infertility.

Modified version of the document

Previously, the disclosure of medical secrets threatened medical workers with administrative or even criminal liability, although, in fact, such data were often disclosed with impunity.

In the explanatory note to the bill, the authorsamendments explained that “children of late adolescence are often not inclined to inform their parents, adoptive parents and caregivers about the problems of the transition period.” This probably refers to problems with alcohol and drugs, sexually transmitted diseases, pregnancy and more.  According to the authors, if parents are kept in the dark, this “violates the duty of the children’s legal representatives to take care of their health” and “is not in the interests” of the minors themselves.

How will the procedure for visiting a doctor for minors change?

From the age of 15, you can still go to the doctor withoutlegal representatives and give informed consent to or refuse medical intervention. However, questions and problems will arise if a minor wants to receive advice or carry out any procedure in a private clinic or hospital, with which a contract for the provision of medical services must be concluded.

Accordingly, in this case the contract mustIt is not the child who must sign, but his legal representative. In accordance with the Civil Code, “transactions with minors from 14 to 18 years of age are concluded with the written consent of their legal representatives, with the exception of small household transactions, to which the provision of medical services does not apply.”

That is, legal representatives must give their consent and therefore at least learn about the fact of seeking medical help, which is a medical secret in itself.

What can they tell the parents of a minor?

All. Parents or legal representatives will need to be told everything the child learns at the appointment. It is not yet known how this information will be provided and in what format. 

It is important to note that information will not occur at the request or request of the parents, but unconditionally. The information just needs to be conveyed. 

What is the reason for the adoption of such a law?

In the explanatory note to the billit was pointed out that the inaccessibility of medical information about older adolescents prevents parents from caring for them, since adolescents often do not tell their parents about sexually transmitted diseases, early pregnancies and sex life in general, as well as about smoking, alcohol consumption and even injuries.

The efforts of the doctor alone, who sees the child, cannotevery day, which has its own communication methods that may not always be appropriate for the child's age or situation, may not be enough. It is unlikely that a doctor can achieve one hundred percent success without the assistance of parents, especially since they will also need many of his recommendations. 

Roman Demyanchuk, Associate Professor, Department of Educational Psychology and Pedagogy, St. Petersburg State University

But opinions differ. Head of the Department of Psychotherapy at the Moscow Medical and Dental University, Professor Vladimir Malygin believes that, despite the immaturity of modern teenagers, in some cases the availability of medical information to parents can harm children.

The authors of the amendments refer to the fact that, according to the Family Code, parents are obliged to take care of the health of their children, and the previous norms do not make it possible to fully realize this right and obligation.

In addition, they write that it will help the parentslearn more about the facts of the social life of adolescents (such as bad relationships with classmates), even though they do not want to talk about it.

However, research shows that a lack of confidentiality when seeking medical help makes it less likely that a teenager will seek that help.

At the same time, foreign medical organizationsrecommend that doctors, if appropriate, encourage their minor patients to discuss medical issues that concern them with their parents. It is believed that this can be beneficial for health: for example, due to the fact that parents will give money for medicines or bring them to appointments.

However, experts acknowledge that there are situations in which the disclosure of medical information to parents would result in harm (for example, beatings or forced marriage).

How did the public react?

A flash mob has already taken place on social networks againstlaw. Users are confident that the abolition of medical confidentiality will not leave minors the right to privacy and will most likely worsen their relationship with their parents. 

Many teenagers decided to express their ownopinion on this issue. As soon as the State Duma adopted the law on the disclosure of medical secrets in the third reading at the end of July this year, the hashtag #Bring Back the Medical Secret topped the top trends on Russian Twitter.

In their stories, many teenagers talk about the fact that they have to hide something from their parents not at all because they want to, but because of the tensions in the family.

Changes in legislation make Russia similarin this regard, to Cyprus, Greece, Hungary, Italy, Latvia, Malta, Romania and Slovakia, where approximately the same standards have been established. In other EU countries, children, subject to certain conditions, are given the opportunity to receive medical care without informing their parents. 

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