Balancing autonomy and expediency within legal parameters: providing primary care to unaccompanied minors

The issue of how primary care clinicians manage unaccompanied minors is not well studied. This month’s article “Treatment of unaccompanied minors in primary care clinics- Caregivers practice and knowledge” begins to fill that gap. The study results reveal that Israeli primary care nurses and doctors often treat unaccompanied minors. Legal parameters offer significant latitude for urgent or simple and ordinary care. Communication to parents afterward is inconsistent. Clinicians also appear to be operating without full understanding of the law in this regard. This contrasts somewhat with the American situation wherein state level laws more clearly proscribe what types of treatment may be offered to adolescents without the prior consent of a parent and also what may remain confidential. Also, in the US, the variability of what is permitted varies widely across the 50 states and territories. The tensions between offering appropriate and timely care, maintaining the trust of patient and family, and doing what is expedient are all important considerations for primary care clinicians who treat unaccompanied minors. This exploratory study identifies current Israeli practice and should serve as an invitation to other national primary care groups to examine their own current state and work towards best practices.