What is the rule of confidentiality, and how does it differ from respecting someone’s privacy?

Confidentiality in Adolescent Patients
Katrina is a 13-year-old female who presents with complaints of nausea and vomiting for 3-weeks. She is accompanied by her mother who is concerned and states, “Katrina is just not herself lately.” Her mother shares with you in private that she is concerned Katrina is bulimic. After her mother leaves the room, Katrina admits to being sexually active and tells you that she has had unprotected intercourse recently with her boyfriend and missed a period.
Her parents do not know she is sexually active, and she does not want her mother to know that a pregnancy test is being done or the result of that test. The pregnancy test comes back positive.
This patient, a 13-year-old, has requested that you not convey to her mother that a pregnancy test has been sent. In other words, she has requested that you respect her confidentiality.
• What is the rule of confidentiality, and how does it differ from respecting someone’s privacy?
• Does the law require you to tell the parents?
• How will you strategize what happens next, e.g., sending a test while the girl waits, but not telling the mom what has been done?
• What if her mother asks what tests you are doing?
Reference
Seattle Children’s Hospital. (n.d.). Confidentiality and Adolescent’s. https://www.seattlechildrens.org/research/centers-programs/bioethics/education/case-based-teaching-guides/confidentiality/case-discussion/

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