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Informed Consent and Confidentiality: Maintaining the Balance among the Rights of the Minor, The parent, and the State

24 July 1998


Client autonomy has always been an issue of central concern to psychologists since they have an ethical mandate to respect people's rights and dignity (Principle D, American Psychological Association [AP A] Ethical Principles of Psychologists and Code of Conduct [APA, 1992], hereafter referred to as the Ethical Code). Legal and societal trends indicate a growing recognition of the importance of granting children and adolescents autonomy and respecting their input regarding matters that affect them. However, there is a general lack of consensus as to "when and how children's input should be. considered, even in everyday matters" (Koocher & Keith-Spiegel, 1990, p. x). The child and adolescent clinician is ethically required to consider the rights of the minor client, alongside "the rights, responsibilities, and relationships that tie the child to his or her parents" (Ehrenreich & Melton, 1983, p. 1285), and the rights of the state.

The use of ethical, legal, and socially sound informed consent and confidentiality practices with minor clients thus serves an important social role as families continue to shift and the role of the minor in society changes. Further research is required to determine the ability of minors experiencing specific psychological problems to provide competent consent. The Ethical Code would also benefit from increased specificity regarding the rights of minor clients as they interact with those of the parent and the state. It is also essential that training programs begin to provide a curriculum which addresses these issues and promotes social activism in students who are interested in the emotional well-being of children and adolescents.


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