WBR1019

Author	[[PageAuthor::Ogheneochuko Ajari, MB.BS, MS [1] (Reviewed by Yazan Daaboul, M.D.)]]
Exam Type	ExamType::USMLE Step 1
Main Category	MainCategory::Ethics
Sub Category	SubCategory::General Principles
Prompt	[[Prompt::A 16-year-old boy is brought to the pediatrician's office for the evaluation of genital ulcers. Upon further questioning, the patient admits to a history of sexual intercourse with his girlfriend. The patient is then informed that work-up for sexually transmitted infections needs to be performed. Following appropriate work-up, the diagnosis of genital herpes is made. Prior to the initiation of therapy, which of the following courses of action is most appropriate?]]
Answer A	AnswerA::Notification of the patient's parents
Answer A Explanation	AnswerAExp::Although the patient is a minor, parental consent is not required in treating sexually transmitted infections.
Answer B	AnswerB::Obtaining permission from the parents to treat
Answer B Explanation	AnswerBExp::Parental consent is not required to treat sexually transmitted infections among minors.
Answer C	AnswerC::Notification of the sexual partner
Answer C Explanation	AnswerCExp::The patient has rights to confidentiality. The physician should recommend that the patient informs the sexual partner for work-up and treatment, but the physician may not violate the right to patient's confidentiality.
Answer D	AnswerD::Recommending that the patient tells his sexual partner
Answer D Explanation	AnswerDExp::The physician should recommend that the patient informs the sexual partner for work-up and treatment, but the physician may not violate the right to patient's confidentiality.
Answer E	AnswerE::Notification of the appropriate state agency
Answer E Explanation	AnswerEExp::Genital herpes is not a reportable sexually transmitted disease.
Right Answer	RightAnswer::D
Explanation	[[Explanation::The patient retains the right to make the decision regarding his treatment but the physician can make recommendations that would be in the best interest of the patient and his partner. The physician should recommend that the patient informs the sexual partner for work-up and treatment, but the physician may not violate the right to patient's confidentiality. Although the patient is a minor, parental consent is not required in treating sexually transmitted infections. The physician cannot notify his parents because of his patient’s rights to privacy and confidentiality, unless he is incapacitated and is not able to make decisions for himself, then confidential medical information could be disclosed to relatives. Educational Objective: The patient retains the right to make the decision regarding his treatment but the physician can make recommendations that would be in the best interest of the patient and his partner. The physician should recommend that the patient informs the sexual partner for work-up and treatment, but the physician may not violate the right to patient's confidentiality. Although the patient is a minor, parental consent is not required in treating sexually transmitted infections. References: First Aid 2015 page 58.]]
Approved	Approved::Yes
Keyword	WBRKeyword::Minor, WBRKeyword::Ethics, WBRKeyword::Sexual partner, WBRKeyword::Genital herpes, WBRKeyword::Behavioral science
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