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Minors can block parents from seeing medical records – but for how long?

Finland's Ministry of Social Affairs and Health has promised that a final version of a national patient database will only give minors the right to block their parents from viewing selected electronic medical records. Currently, patients as young as 10 years old can prevent their guardians from viewing data such as doctor’s visits, prescriptions and lab results in the national patient database.

Image: Ismo Pekkarinen / AOP

According to officials from the Ministry of Social Affairs and Health, once finalised, the nationwide electronic patient records database Omakanta will allow parents to see their children's medical records – except for information that children don't want them to see.

For now however, the system prevents the parents of children aged 10 years and older from viewing their child’s medical records. Such information may include details about doctor’s visits, prescriptions and the results of lab tests. The same age limit is also used in the electronic appointment system of the Southern Karelia social and health care district.

According to existing legislation, underage patients ihave the right to prevent their guardians from accessing information about their health status, if they are able to decide on care regimes themselves. However the current patient database has now highlighted issues relating to privacy as well as health advocacy on behalf of children.

The Patient Act, introduced in 1992, has always contained provisions protecting minors' rights to self-determination. The law prioritises the confidentiality of the care relationship above the right of parents to have information about their children. However, there is no room for finer shades of meaning in the digital world.

"In the healthcare system, matters are considered on a case-by-case basis. The digital world is such that you have to draw some kind of artificial line," said Tuomas Kumpula, a patient ombudsman with the Southern Karelia social and healthcare district, known as Eksote.

Parents rattled by broad rights granted to children

He noted that at a doctor’s discretion, even underage children could prevent could prevent their parents from accessing information about their health status. Kumpula sided with the provisions of the law.

"It is difficult to disagree with the law. Patient treatment takes place on the basis of an understanding with them, there is no age limit. An 18-year age limit is just as artificial as a digitally-defined age limit."

The patient advocate sought to calm agitated parents, saying that there is no cause for concern. He pointed out that the age limits enshrined in the law do not mean that parents are categorically banned from seeing their children’s patient data.

"Sometimes it may well be important that this kind of opportunity exists for a minor," Kumpula said, adding that he has encountered the issue in his work.

He said that parents sometimes contact him when they have problems getting information about their children’s patient data.

"Usually in these cases the issue has been that for some reason, relations between the parents and the child are frayed. The child may have been capable of using their veto right and has used it," he explained.

"We need to understand that the age restrictions in the electronic systems don’t prevent parents from tasks such as making an appointment [for their child]. Guardians can also accompany children on doctor’s visits, as they have been able to up to this point. Of course it may be relevant to ask an underage child if that’s ok."

Teen could block information about birth control pills

In 2011, officials launched the electronic Omakanta patient medical database to users 18 years and older. In 2016, the parents of children under the age of 10 were allowed to use it for their charges, however the system is yet to be completed.

"The aim is to allow for viewing of data for children over the age of 10 and proxy transactions as soon as possible," said IT adviser Maritta Korhonen of the Social Affairs and Health Ministry.

She explained that the final system would allow parents to see their underage children's health records, express in cases where the child expressly requests that it is not shared with them.

"Let’s imagine a 16-year-old girl goes to the doctor and wants birth control pills. She says she doesn’t want her parents to know. The doctor evaluates whether or not the girl is mature enough to decide about her own care and decides that she is. The doctor puts a mark in the system about the visit indicating that the parents are not to get information about it," she added.

In the future, the parents of minors over the age of 10 will be able to see their minors’ medical data in the electronic system. However the visits that the child does not want them to see will remain invisible to them, according to the provisions of the Patient Act.

The ministry’s Korhonen said it remains unclear when the system will be available for widespread use.

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