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Contact the patient's parents to obtain consent
3%
1/35
Recommend sexually-transmitted infection screening and provide the requested prescription
57%
20/35
Refer the patient for counseling and recommend sexually-transmitted infection screening
9%
3/35
Perform urine drug screen
0%
0/35
Advise against oral contraceptive medications and recommend condom use instead
11%
4/35
Select Answer to see Preferred Response
In most states, physicians may diagnose and treat sexually-transmitted infections and provide contraceptive medications to minors without parental consent. Treatment of most conditions for minors requires parental consent. However, there are a few notable exceptions in which parental consent is not required. These exceptions include: treatment of sexually-transmitted infections, pregnancy, alcohol or substance abuse, and contraception. Klein discusses the management of sexually active adolescents. For public health concerns, every state allows the treatment of sexually-transmitted infections in minors without parental consent. In the presented case, this patient is at high risk of sexually-transmitted infections given her age and multiple sexual partners, and thus should be screened for infection. If infected, treatment should be administered. Bartholome discusses the Academy of Pediatrics' stance on consent for minors in situations relating to oral contraceptives. While the Academy encourages obtaining parental consent when possible, it frequently is still appropriate to prescribe contraceptives in the absence of consent. However, legal requirements vary by state, and thus physicians must ensure compliance with local laws. Illustration A summarizes the United States Preventative Services Task Force (USPSTF) recommendations for risk assessment and counseling related to sexually-transmitted infections in adolescents. Incorrect answers: Answer 1: Parental consent is generally not needed for prescribing oral contraceptives. Answer 3: While recommending sexually-transmitted infection screening is certainly reasonable, the patient can also be prescribed contraceptives. Answer 4: Drug screening is not indicated in this situation. However, it is appropriate to perform additional history and screening related to adolescent high risk behaviors. Answer 5: While condoms are a good recommendation given this patient's high-risk sexual behaviors, condoms should be recommended in addition to the requested oral contraceptives, as oral contraceptives are substantially more effective at preventing pregnancy.
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