Doctors’ criminal law duty to report consensual sexual activity between adolescents: legal and clinical issues

Mathews, Ben; Sanci, Lena A

doi:10.5694/mja2.51163

Topics

Ethics and law

General medicine

Health occupations

Health services administration

Pediatric medicine

Sexual health

Social determinants of health

Women's health

Laws requiring doctors to report consensual adolescent sexual activity present legal, clinical and ethical problems

Many Australian teenagers engage in consensual sexual intercourse with similar aged peers.1 They require confidential medical care, including contraception and sexually transmitted infection testing. However, adolescents’ rights to access medical care may confront legal barriers.

1 Queensland University of Technology, Brisbane, QLD
2 Johns Hopkins University, Baltimore, MD, USA
3 University of Melbourne, Melbourne, VIC

Correspondence: b.mathews@qut.edu.au

Competing interests:

No relevant disclosures.

1. Fisher CM, Waling A, Kerr L, et al. 6th national survey of Australian secondary students and sexual health 2018 (ARCSHS Monograph Series No. 113). Melbourne: Australian Research Centre in Sex, Health and Society, La Trobe University, 2019. http://teenhealth.org.au/resources/Reports/SSASH%202018%20National%20Report%20-%20V10%20-%20web.pdf (viewed June 2021).
2. Tylee A, Haller DM, Graham T, et al. Youth‐friendly primary‐care services: how are we doing and what more needs to be done? Lancet 2007; 369: 1565–1573.
3. Mazur A, Brindis CD, Decker MJ. Assessing youth‐friendly sexual and reproductive health services: a systematic review. BMC Health Serv Res 2018; 18: 216.
4. Robards F, Kang M, Steinbeck K, et al. Health care equity and access for marginalised young people: a longitudinal qualitative study exploring health system navigation in Australia. Int J Equity Health 2019; 18: 41.
5. Patton GC, Sawyer SM, Santelli JS, et al. Our future: a Lancet commission on adolescent health and wellbeing. Lancet 2016; 387: 2423–2478.
6. Sanci LA, Sawyer SM, Haller DM, et al. Confidential health care for adolescents: reconciling clinical evidence with family values. Med J Aust 2005; 183: 410–414. https://www.mja.com.au/journal/2005/183/8/confidential-health-care-adolescents-reconciling-clinical-evidence-family-values
7. Mathews B, Smith M. Children and consent to medical treatment. In: White B, McDonald F, Willmott L, editors. Health law in Australia. Sydney: Thomson Reuters, 2018: 159–206.
8. Steinberg L, Icenogle G. Using developmental science to distinguish adolescents and adults under the law. Ann Rev Dev Psychol 2019; 1: 21–40.
9. Icenogle G, Steinberg L, Duell N, et al. Adolescents’ cognitive capacity reaches adult levels prior to their psychosocial maturity: evidence for a “maturity gap” in a multinational, cross‐sectional sample. Law Hum Behav 2019; 43: 69–85.
10. Mathews B, Collin‐Vézina D. Child sexual abuse: toward a conceptual model and definition. Trauma Violence Abuse 2019; 20: 131–148.
11. Sawyer SM, Azzopardi PS, Wickremarathne D, et al. The age of adolescence. Lancet Child Adolesc Health 2018; 2: 223–228.
12. Petroni S, Das M, Sawyer SM. Protection versus rights: age of marriage versus age of sexual consent. Lancet Child Adolesc Health 2019; 3: 274–80.
13. Office of Public Prosecutions Victoria. Policy of the Director of Public Prosecutions for Victoria. Melbourne: OPP Victoria, 2021. http://www.opp.vic.gov.au/Resources/Policies (viewed June 2021).
14. Office of the Director of Public Prosecutions New South Wales. Prosecution guidelines. Sydney: ODPP NSW, 2021. https://www.odpp.nsw.gov.au/prosecution-guidelines (viewed June 2021).
15. Mathews B. A taxonomy of duties to report child sexual abuse: legal developments offer new ways to facilitate disclosure. Child Abuse Neg 2019; 88: 337–347.
16. Parliament of Victoria Family and Community Development Committee. Betrayal of trust: inquiry into the handling of child abuse by religious and other non‐government organisations. Melbourne: FCDC, 2013. http://www.parliament.vic.gov.au/component/content/article/340-inquiry-into-the-handling-of-child-abuse-by-religious-and-other-organisations/1788-report (viewed Sept 2020).
17. Australian Government Royal Commission into Institutional Responses to Child Sexual Abuse. Criminal justice report. Sydney: Commonwealth of Australia, 2017. https://www.childabuseroyalcommission.gov.au/criminal-justice (viewed Sept 2020).
18. Royal Australian College of General Practitioners. Guidelines for preventive activities in general practice, 9th edition. Melbourne: RACGP, 2016. https://www.racgp.org.au/download/Documents/Guidelines/Redbook9/17048-Red-Book-9th-Edition.pdf (viewed June 2021).
19. Sanci L, Webb M, Hocking J. Risk‐taking behaviour in adolescents. Aust J Gen Pract 2018; 47: 829–834.
20. Australian Medical Association. Code of ethics 2004. Editorially revised 2006. Revised 2016. Canberra: AMA, 2016. https://ama.com.au/position-statement/code-ethics-2004-editorially-revised-2006-revised-2016 (viewed Sept 2020).
21. Australian Medical Association. Position statement: sexual and reproductive health. Canberra: AMA, 2014. https://ama.com.au/position-statement/sexual-and-reproductive-health-2014 (viewed Sept 2020).
22. Mathews B, Collin‐Vézina D. Child sexual abuse: raising awareness and empathy is essential to promote new public health responses. J Public Health Policy 2016; 37: 304–314.

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