Legal and ethical issues in adolescents' health care

This review examines confidentiality, consent to health care and research involving adolescents in regard to legal and ethical aspects. Adolescents are more likely to seek health care if their provider assures confidentiality, but in providing confidential care a balance should be considered between the needs of the adolescent patient, parents, and provider. The vast majority of countries set the legal age at 18, but from the age of 14 years adolescents' capability for medical decision-making may be considered already similar to adult capacity. Instead of chronological age of consent, permission for consent must take into consideration the adolescent's capacity for understanding the medical treatment or the research in which the adolescent is requested to be involved. At all circumstances adolescent's assent for both medical treatment and research is always mandatory. Involving adolescents in research should be based on a careful assessment of risks and benefits together with understanding of the developing capabilities of the adolescent.