Imagine you are a GP and a 15 year old female comes to you asking for the contraceptive pill to use as contraception. She does not want her parents to know about this. Describe what issues this raises and how you could go about addressing this?

This style of question is common at interview. Crucially it is split into two parts and it requires both parts answering in full. Although these might seem like scary or perhaps even embarrassing topics to talk about at interview these would be topics a doctor would have to feel comfortable talking about.-Ethical issues this raises?This situation raises a few important ethical issues. Firstly the issue of competence, competence is the ability for someone to make their own decisions about their healthcare. It is assume all adults (those over 16) have competence however for children under 16 competence must be assessed. We do this using the fraser competence rules. Another issue is confidentiality, does this young girl have the right to have her health information protected from her parents? The answer is almost always yes, unless the young girl is in danger of harm, if for example the relationship is abusive or with a person in a position of responsibility (such as a teacher), then we have a duty of confidentiality to this girl and therefore we cannot tell her parents anything unless she gives us permission to.-How do you go about this consultation?It is important to first ascertain some background information, we sometimes call this taking a history, it is appropriate to ask her how old the person she is having intercourse with is, that she is in a safe environment and what they have been using as contraception until now? It is also important to try to gently persuade her to talk to her parents about this, if she still refuses to want her parents to be informed then you must assess her competence and decide if she can have the medication. In the majority of these cases so long as the young person is mature, understands the benefits and the risks usually the contraceptive is given as we would much rather young individuals are having safe intercourse. It is also important to inform her that the oral contraceptive will not prevent against sexually transmitted infections.