Answer Happy

CASE: BRENDA CARTAGENA You started covering the office for Dr. Rivera a few days ago. He will be on educational leave for three weeks. You are about to see Brenda Cartagena, who has been Dr. Rivera's patient for several years. Her 16-year-old daughter, Jennifer, is also a patient of Dr. Rivera. A few months ago, Dr. Rivera prescribed the birth control pill for Jennifer because she was sexually active. Jennifer asked several informed questions and was fully aware of the risks and benefits of taking the pill. Dr. Rivera wrote in his notes that he felt she was fully competent to make that decision. Jennifer told Dr. Rivera in no uncertain terms that she did not want her mother to know she was on the pill or why she was being prescribed the pill. Two days ago, you saw Jennifer to renew her prescription for the pill. You agree with Dr. Rivera's assessment of her competence. The mother, Brenda, has subsequently become suspicious about Jennifer's visits to the doctor's office and has made this appointment to discuss the issue. You have a very busy office today and only have 15 minutes to see her. Brenda and Jennifer's father were divorced 6 years ago. Their divorce was not amicable and there 6 were fights over custody. Brenda's relationship with Jennifer is somewhat strained. Whenever she asks Jennifer about her activities, the daughter she accuses her of prying and most attempts at conversation end in an argument. Last week while preparing clothes to take to the cleaners, Brenda found an appointment card from the doctor's office in the pocket of Jennifer's jacket. It listed 2 appointments about which she knew nothing. She became worried that Jennifer may be sexually active and suspected that the appointments were for getting "the pill". Brenda is now in your office expecting to find out the reason for Jennifer's visits. She thinks she has a right to know about her child's health and medications because Jennifer is only a child (and her only child). She is very worried about Jennifer's best interests. Brenda really doesn't expect to meet with any resistance in obtaining information about Jennifer's visits. She tells the doctor: "You're not the parent, I am. Legally she's still my child. I'm the person who's responsible. I'll have to bear the consequences." Guide questions for case: Brenda Cartagena 1. Discuss the ethical principles that apply to this case. 2. Since Jennifer is a minor, were the doctors at fault for treating her without her mother's consent? 3. Are there any special ethical and legal considerations pertinent to this case? 4. Discuss your best course of action in this situation.