Perspectives on Confidential Care for Adolescent Girls

The findings of this study describe mothers’ and daughters’ experiences of an important turning point in adolescent care: the initiation of gynecological and confidential care. The findings are interesting in themselves: who would have thought that confidential care, mandated by law in New York State--viewed by many of us as a moral advance in guaranteeing reproductive rights to adolescents—-would be viewed with such suspicion by mothers and such trepidation by daughters?

But the findings also illustrate more general points with implications for the practice of family medicine. First of all, they perfectly illustrate the fact that when patients and physicians occupy different cultural worlds, patients may not share the moral premises that underlie many of our primary care interventions.Second, they indicate that the manner in which we carry out these interventions—the words we use-- make a huge difference--don’t, for example, ask an adolescent girl in her mother’s presence whether she would prefer her mother to leave the room! And third, as the authors point out, the findings provide further evidence of the importance of continuity of care: preparing mothers and daughters early and often for confidential care, explaining its purpose, and giving both a chance to express concerns.

Competing interests:   None declared