Scenario Analysis: This scenario presents a common challenge in adolescent medicine: integrating new, evidence-based guidelines into established clinical workflows. The professional challenge lies in balancing the imperative to provide optimal care based on current research with the practical realities of busy clinical practice, physician buy-in, and patient/family engagement. It requires careful consideration of how to implement change effectively and ethically, ensuring patient safety and adherence to professional standards. Correct Approach Analysis: The best approach involves a systematic, multi-faceted strategy that prioritizes education, stakeholder engagement, and gradual implementation with ongoing evaluation. This begins with a thorough review of the new evidence-based guidelines by the clinical team to understand their implications. Subsequently, it necessitates open communication with all relevant staff, including physicians, nurses, and support personnel, to discuss the rationale for the changes and address any concerns. Pilot testing the new protocols in a controlled manner, perhaps with a specific patient subgroup or on designated days, allows for refinement before full rollout. Crucially, this approach includes mechanisms for ongoing monitoring of patient outcomes and staff adherence, with feedback loops for continuous improvement. This aligns with ethical principles of beneficence (acting in the patient’s best interest by adopting superior care methods) and non-maleficence (avoiding harm by ensuring the new practices are safe and effective). It also reflects professional responsibility to stay current with medical knowledge and implement best practices, as expected by professional bodies and regulatory oversight. Incorrect Approaches Analysis: Implementing changes without adequate team buy-in or understanding, such as immediately mandating new protocols without prior discussion or training, risks resistance, errors, and a decline in morale. This fails to uphold the principle of professional collaboration and can lead to inconsistent application of the guidelines, potentially compromising patient care. Adopting new practices solely based on anecdotal evidence or personal preference, without a systematic review of the supporting research and guidelines, deviates from the core tenet of evidence-based medicine. This approach is ethically problematic as it prioritizes individual opinion over established scientific consensus, potentially leading to suboptimal or even harmful care. Focusing exclusively on the administrative aspects of implementation, such as updating electronic health record templates, without addressing the clinical rationale, staff training, and patient education, overlooks the human element of change. This can result in superficial compliance without genuine understanding or effective integration into patient care, failing to achieve the intended improvements in outcomes. Professional Reasoning: Professionals should approach the implementation of evidence-based practices by first understanding the evidence and its implications. This involves a critical appraisal of the research and guidelines. Next, they should engage all relevant stakeholders in a transparent discussion about the proposed changes, fostering a collaborative environment. A phased implementation, including pilot testing and ongoing evaluation, allows for adaptation and refinement. Finally, continuous monitoring of outcomes and feedback mechanisms are essential for ensuring sustained adherence and maximizing the benefits of the new practices. This systematic and collaborative approach ensures ethical and professional standards are met while optimizing patient care.

This scenario presents a professional challenge because the physician must navigate the complex interplay of adolescent autonomy, parental rights, and the potential impact of family dynamics on the adolescent’s health and well-being. Balancing these competing interests requires careful judgment, adherence to ethical principles, and an understanding of relevant legal and professional guidelines. The physician must assess the situation to determine the most appropriate course of action that prioritizes the adolescent’s best interests while respecting the family unit. The best professional approach involves a comprehensive assessment of the family’s functioning and the adolescent’s attachment style within that context. This includes open communication with both the adolescent and the parents, exploring their perspectives, and understanding the nature of their relationships. By identifying the specific family influences and attachment patterns (e.g., secure, anxious-preoccupied, dismissive-avoidant, fearful-avoidant), the physician can tailor interventions to address any maladaptive dynamics that may be impacting the adolescent’s health, mental well-being, or adherence to treatment. This approach aligns with ethical principles of beneficence and non-maleficence, as it seeks to understand and address the root causes of potential issues, and respects the adolescent’s developing autonomy while acknowledging the family’s role. It also implicitly supports the American Board of Family Medicine’s commitment to comprehensive adolescent care, which recognizes the importance of social and familial determinants of health. An incorrect approach would be to solely focus on the adolescent’s stated concerns without exploring the underlying family dynamics. This fails to acknowledge that adolescent behaviors and health issues are often influenced by their environment and relationships. Ethically, this could lead to incomplete diagnosis and treatment, potentially missing crucial contributing factors. Another incorrect approach would be to dismiss parental concerns outright and exclusively prioritize the adolescent’s wishes, even if the adolescent is exhibiting signs of significant distress or risk. This disregards the legal and ethical responsibilities physicians often have to involve parents in the care of minors, especially when safety is a concern, and can alienate the family unit, hindering collaborative care. Finally, making assumptions about the family’s functioning based on stereotypes or limited information, without direct assessment, is professionally unacceptable. This can lead to misinterpretations, biased care, and a failure to build trust with the family. Professionals should employ a decision-making framework that begins with a thorough, non-judgmental assessment of the adolescent and their family system. This involves active listening, open-ended questioning, and observation of interactions. The physician should then integrate this information with their clinical knowledge of adolescent development and attachment theory. Ethical considerations, including confidentiality, informed consent (and assent from the adolescent), and the duty to protect, should guide the process. When conflicts arise, the physician should strive for a collaborative approach, seeking solutions that respect the needs and rights of all parties involved, with the adolescent’s well-being as the paramount concern.

This scenario is professionally challenging because it requires balancing an adolescent’s evolving need for privacy with parental rights and responsibilities, all within the context of medical ethics and evolving legal standards. The physician must navigate the delicate balance of fostering trust with the adolescent while ensuring appropriate parental involvement and safeguarding the adolescent’s well-being. Careful judgment is required to determine when and how to involve parents without alienating the adolescent or violating confidentiality principles. The best professional approach involves a nuanced discussion with the adolescent about confidentiality limits, particularly concerning issues that pose a risk of harm to themselves or others, and then collaboratively deciding how to involve parents. This approach respects the adolescent’s growing autonomy and right to privacy, while also acknowledging the physician’s ethical and legal obligations to ensure safety. By openly discussing confidentiality with the adolescent and seeking their assent or consent for parental involvement, the physician builds trust and empowers the adolescent. This aligns with ethical principles of beneficence and non-maleficence, as well as the evolving legal recognition of adolescent decision-making capacity. It also prepares the adolescent for future healthcare interactions where they will be expected to participate more actively in their care decisions. An incorrect approach would be to immediately disclose all information to the parents without first discussing it with the adolescent. This breaches the adolescent’s trust, potentially damaging the therapeutic relationship and discouraging them from seeking future medical care. It also fails to recognize the adolescent’s increasing capacity for decision-making and their right to privacy, which are increasingly protected by ethical guidelines and legal precedents. Another incorrect approach would be to refuse any parental involvement, even when the adolescent’s safety is clearly at risk. While respecting confidentiality is crucial, physicians have a duty to protect vulnerable patients. Ignoring potential parental support or intervention when an adolescent is at significant risk of harm would be an ethical failure, potentially violating the principle of non-maleficence. Finally, an incorrect approach would be to make assumptions about the adolescent’s capacity or the parental situation without direct assessment and communication. This can lead to misjudgments that harm the adolescent’s relationship with their parents or their healthcare provider, or fail to provide necessary support. The professional reasoning process should involve: 1) assessing the adolescent’s immediate safety and well-being; 2) understanding the specific nature of the peer relationship issue and its potential impact; 3) engaging in an open and honest discussion with the adolescent about confidentiality and the limits thereof; 4) collaboratively determining the best course of action regarding parental involvement, prioritizing the adolescent’s safety and therapeutic alliance; and 5) documenting the assessment, discussion, and decision-making process thoroughly.

This scenario is professionally challenging because it requires balancing the need for comprehensive mental health assessment with the practical limitations of a busy adolescent clinic, while also ensuring patient privacy and informed consent. The physician must select a screening tool that is evidence-based, age-appropriate, and efficient, without compromising the quality of care or potentially alienating the adolescent patient. Careful judgment is required to avoid over-reliance on a single tool or a superficial approach that misses critical issues. The best approach involves utilizing a validated, age-appropriate mental health screening tool that is designed for brief administration in a primary care setting and has established psychometric properties for the adolescent population. This approach is correct because it aligns with best practices in adolescent medicine, emphasizing proactive identification of mental health concerns. The American Academy of Pediatrics (AAP) and other professional organizations recommend routine mental health screening for adolescents. Using a validated tool ensures that the screening is sensitive and specific enough to detect potential issues, and its brevity respects the time constraints of a clinical encounter. Furthermore, integrating this screening into routine well-child visits normalizes mental health discussions and reduces stigma. Ethical considerations of beneficence (acting in the patient’s best interest) and non-maleficence (avoiding harm) are met by systematically assessing for mental health conditions that could otherwise go undiagnosed and untreated. An incorrect approach would be to rely solely on the adolescent’s verbal report of their emotional state without using a standardized screening tool. This is professionally unacceptable because subjective reporting can be influenced by a desire to please the clinician, fear of judgment, or a lack of self-awareness regarding the severity of their symptoms. It fails to systematically assess for common mental health conditions like depression, anxiety, or suicidal ideation, which may not be spontaneously disclosed. This approach risks missing significant mental health issues, violating the principle of beneficence. Another incorrect approach would be to administer a lengthy, research-grade diagnostic interview during a routine 15-minute appointment. This is professionally unacceptable because it is not feasible within the time constraints of a typical primary care visit, leading to rushed assessments or incomplete care for other medical needs. While thorough, it fails to consider the practical realities of clinical workflow and patient engagement, potentially overwhelming the adolescent and clinician. This approach is inefficient and may not be sustainable for routine screening. A further incorrect approach would be to use a screening tool designed for adults without considering its adaptation or validation for adolescents. This is professionally unacceptable because the language, cognitive demands, and symptom presentation of mental health conditions can differ significantly between adult and adolescent populations. A tool not validated for adolescents may have poor sensitivity or specificity in this age group, leading to inaccurate results (false positives or false negatives) and potentially inappropriate interventions or missed diagnoses. This violates the principle of providing evidence-based care tailored to the specific developmental stage of the patient. Professionals should employ a decision-making framework that prioritizes evidence-based, age-appropriate, and efficient screening methods. This involves staying current with recommendations from professional organizations, selecting tools with demonstrated reliability and validity for adolescents, and integrating screening into routine care in a way that facilitates open communication and timely follow-up for any identified concerns. The process should involve assessing the patient’s developmental stage, the clinical context, and the availability of resources for further evaluation and management.

Scenario Analysis: This scenario is professionally challenging because it requires balancing the adolescent’s evolving autonomy with parental rights and responsibilities, all within the framework of established medical ethics and evolving legal standards for adolescent healthcare. The physician must navigate potential conflicts between the adolescent’s expressed wishes and the parents’ perceived best interests, while ensuring confidentiality and informed consent are appropriately managed. Correct Approach Analysis: The best professional practice involves a comprehensive assessment that prioritizes open communication with both the adolescent and the parents, while respecting the adolescent’s increasing capacity for decision-making. This approach acknowledges the legal and ethical principles of informed consent and assent, recognizing that as adolescents mature, their involvement in healthcare decisions should increase. It involves a thorough evaluation of the adolescent’s emotional and social development, understanding their cognitive abilities, and assessing their understanding of their health status and treatment options. This approach aligns with the ethical imperative to promote patient autonomy and beneficence, ensuring that decisions are made with the adolescent’s best interests at heart, and that they feel heard and respected. Incorrect Approaches Analysis: One incorrect approach involves solely relying on parental consent without adequately involving the adolescent in the decision-making process, even when the adolescent demonstrates a clear understanding of their situation and treatment options. This fails to respect the adolescent’s developing autonomy and can undermine their engagement with healthcare. Another incorrect approach is to exclusively prioritize the adolescent’s wishes without considering the parents’ legal rights and responsibilities, especially if the adolescent’s expressed desires could lead to significant harm or are based on a misunderstanding of the situation. This can create ethical and legal conflicts and may not serve the adolescent’s long-term well-being. A further incorrect approach is to dismiss the adolescent’s concerns or capacity for decision-making based solely on their age, without a thorough assessment of their maturity and understanding. This paternalistic stance can alienate the adolescent and lead to non-adherence to treatment plans. Professional Reasoning: Professionals should employ a tiered approach to decision-making in adolescent healthcare. This begins with a thorough assessment of the adolescent’s developmental stage, cognitive capacity, and understanding of their health. Open and honest communication with both the adolescent and their parents is crucial, fostering a collaborative environment. The physician must then determine the level of the adolescent’s capacity to participate in decision-making, applying principles of informed consent and assent. When conflicts arise, the focus should remain on the adolescent’s best interests, seeking to mediate between adolescent and parental perspectives while adhering to legal and ethical guidelines regarding confidentiality and parental involvement.

Scenario Analysis: This scenario is professionally challenging because it requires the clinician to balance the need for a thorough adolescent physical examination with the patient’s potential discomfort, privacy concerns, and developmental stage. Adolescents are often more self-conscious than younger children, and a poorly executed or overly intrusive examination can lead to distrust, non-compliance, and avoidance of future healthcare. The clinician must demonstrate sensitivity, respect, and a clear understanding of age-appropriate techniques while ensuring all necessary components of the exam are completed to identify potential health issues relevant to adolescent development. Correct Approach Analysis: The best approach involves a systematic, head-to-toe examination that prioritizes patient comfort and privacy at every step. This includes explaining each part of the exam to the adolescent beforehand, obtaining verbal assent before proceeding with sensitive portions, and ensuring appropriate chaperones are present when indicated by policy or patient preference. The examination should be conducted in a manner that allows the adolescent to maintain as much dignity as possible, such as by draping appropriately and only exposing the area being examined. This approach aligns with ethical principles of patient autonomy, beneficence, and non-maleficence, and is supported by professional guidelines for adolescent healthcare which emphasize patient-centered care and respect for privacy. Incorrect Approaches Analysis: One incorrect approach involves proceeding with a rapid, checklist-driven examination without adequate explanation or patient engagement. This fails to acknowledge the adolescent’s developmental stage and potential for anxiety, potentially leading to a superficial assessment and missed findings. It also violates the principle of informed consent and patient respect. Another incorrect approach is to skip or significantly abbreviate components of the physical exam deemed “sensitive” without a clear clinical rationale or discussion with the adolescent. This can lead to missed diagnoses of conditions prevalent in adolescence, such as gynecological or genitourinary issues, thereby compromising the principle of beneficence. A third incorrect approach is to conduct the examination in a way that disregards privacy, such as leaving the adolescent undressed for extended periods or having multiple individuals present without clear justification or consent. This breaches patient confidentiality and can cause significant distress, eroding the patient-provider relationship and potentially violating professional standards of care. Professional Reasoning: Professionals should approach the adolescent physical examination with a framework that integrates clinical knowledge with patient-centered communication and ethical considerations. This involves: 1) Pre-examination preparation: Reviewing the patient’s history and anticipating potential adolescent-specific health concerns. 2) Patient engagement: Clearly explaining the purpose and steps of the examination, addressing any concerns, and obtaining assent. 3) Systematic execution: Performing a comprehensive exam while prioritizing comfort, privacy, and dignity. 4) Post-examination discussion: Reviewing findings and answering questions. This systematic and respectful approach ensures both diagnostic accuracy and a positive healthcare experience for the adolescent.

Scenario Analysis: This scenario is professionally challenging because it requires the clinician to navigate the ethical and practical implications of a patient’s cognitive development in relation to their capacity to understand and consent to medical treatment. The adolescent patient is exhibiting behaviors that suggest they may not fully grasp the long-term consequences of their choices, creating a tension between respecting their burgeoning autonomy and ensuring their well-being. This requires a nuanced approach that balances legal requirements for consent with developmental considerations. Correct Approach Analysis: The best professional practice involves a comprehensive assessment of the adolescent’s cognitive maturity and understanding of the proposed treatment, its risks, benefits, and alternatives, in the context of Piaget’s stages of cognitive development. This approach acknowledges that while adolescents are moving towards abstract thought, their capacity for complex decision-making is still developing. The clinician should engage in a detailed discussion with the patient, using age-appropriate language and concrete examples to gauge their comprehension. If the adolescent demonstrates sufficient understanding and maturity to make an informed decision, their assent should be sought and documented, while also involving parents or guardians as appropriate, especially if the treatment is significant or carries substantial risks. This aligns with ethical principles of beneficence and respect for autonomy, while also adhering to the legal framework that recognizes varying levels of capacity in minors. Incorrect Approaches Analysis: One incorrect approach is to solely rely on the patient’s stated desire for a particular treatment without a thorough assessment of their cognitive understanding. This fails to acknowledge the developmental limitations that may exist, potentially leading to a decision that is not truly informed and could be detrimental to the patient’s long-term health. This approach neglects the ethical duty of beneficence and the professional responsibility to ensure patient understanding. Another incorrect approach is to automatically defer to parental wishes without adequately assessing the adolescent’s own understanding and capacity. While parental involvement is crucial, particularly for younger adolescents or those with significant cognitive limitations, this approach can undermine the adolescent’s developing autonomy and their right to be heard in decisions affecting their own bodies. It may also overlook situations where the adolescent possesses a greater understanding than the parents assume. A further incorrect approach is to dismiss the adolescent’s input entirely and proceed solely based on parental consent, regardless of the adolescent’s apparent level of understanding or maturity. This is ethically problematic as it disregards the adolescent’s developing autonomy and can lead to resentment and non-adherence to treatment. It also fails to recognize that as adolescents mature, their capacity for informed decision-making increases, and their assent becomes increasingly important. Professional Reasoning: Professionals should employ a developmental-informed approach to assessing capacity. This involves understanding the typical cognitive milestones outlined by theorists like Piaget and applying this knowledge to individual patient assessments. The process should be iterative, involving open communication, clear explanations, and opportunities for the patient to ask questions and express concerns. When assessing an adolescent’s capacity, professionals should consider their ability to: understand the relevant information, appreciate the situation and its consequences, reason through the options, and communicate a choice. The level of parental involvement should be tailored to the adolescent’s age, maturity, and the complexity of the medical decision.

This scenario is professionally challenging because it requires balancing the adolescent’s evolving cognitive abilities and desire for autonomy with the legal and ethical obligations to ensure their well-being and safety. The physician must assess the adolescent’s capacity to understand information and make decisions, which is not a static concept but rather develops over time. Careful judgment is required to avoid either overestimating or underestimating the adolescent’s comprehension and decision-making skills, which could lead to inappropriate care or infringement on their rights. The best approach involves a comprehensive assessment of the adolescent’s cognitive development and decision-making capacity in the context of their specific health issue. This includes evaluating their ability to understand the nature of their condition, the proposed treatment options, the potential risks and benefits, and the alternatives. It also requires assessing their ability to communicate their preferences and to make a voluntary choice. This approach aligns with ethical principles of beneficence, non-maleficence, and respect for autonomy, and is supported by guidelines from professional organizations that emphasize individualized assessment of adolescent assent and consent. An incorrect approach would be to automatically assume that all adolescents below a certain age lack the capacity to participate in their healthcare decisions. This fails to recognize the variability in cognitive development and can lead to paternalistic care that undermines the adolescent’s developing autonomy and can erode trust. Another incorrect approach is to solely rely on parental consent without any attempt to involve the adolescent in the decision-making process, even when they demonstrate a clear understanding of their situation and express preferences. This disregards the adolescent’s right to be informed and to have their voice heard, which is increasingly important as they mature. Finally, an approach that prioritizes the adolescent’s immediate desires over their long-term well-being, without adequate consideration of potential risks or the input of guardians where appropriate, would also be professionally unacceptable. Professionals should employ a decision-making framework that begins with an assumption of capacity, followed by an individualized assessment of the adolescent’s understanding and decision-making abilities. This assessment should be dynamic and revisited as needed. When capacity is uncertain or limited, the professional should involve parents or guardians while still striving to involve the adolescent to the greatest extent possible, respecting their developing autonomy.

This scenario presents a professional challenge due to the sensitive nature of adolescent eating disorders, requiring a nuanced approach that balances immediate nutritional intervention with long-term psychological and developmental considerations. The physician must navigate potential conflicts between parental desires, adolescent autonomy, and evidence-based medical practice, all while adhering to ethical principles and professional guidelines. The best approach involves a comprehensive assessment that prioritizes the adolescent’s overall well-being, integrating nutritional status with mental health and developmental stage. This includes a thorough history from the adolescent and parents, a physical examination, and appropriate laboratory investigations to identify medical complications. Crucially, it necessitates open communication with the adolescent about their concerns and goals, fostering a collaborative treatment plan. This aligns with ethical principles of beneficence and non-maleficence, ensuring that interventions are tailored to the individual’s needs and minimize harm. It also respects the adolescent’s developing autonomy, as mandated by ethical guidelines that recognize the increasing capacity of adolescents to participate in their healthcare decisions. Furthermore, it adheres to best practices in adolescent medicine, which emphasize a biopsychosocial model of care. An approach that solely focuses on rapid weight restoration without addressing the underlying psychological factors or involving the adolescent in decision-making is professionally unacceptable. This failure to consider the psychological component of an eating disorder can lead to resistance, relapse, and a breakdown in the therapeutic alliance. It also risks undermining the adolescent’s autonomy and may not align with ethical requirements for informed consent, especially if the adolescent is deemed to have sufficient maturity to understand their condition and treatment options. Another professionally unacceptable approach is to defer entirely to parental directives regarding nutritional goals without adequately assessing the adolescent’s perspective or medical needs. While parental involvement is crucial, an overreliance on parental wishes can disregard the adolescent’s agency and potentially lead to treatment plans that are not medically indicated or psychologically beneficial for the adolescent. This can create ethical conflicts by not fully upholding the principle of patient-centered care and potentially overlooking signs of coercion or undue influence. Finally, an approach that delays comprehensive nutritional and psychological assessment due to concerns about upsetting the parents is also professionally flawed. While sensitivity to parental concerns is important, delaying necessary medical and psychological interventions based on potential parental discomfort can be detrimental to the adolescent’s health. This prioritizes parental comfort over the adolescent’s immediate medical and psychological needs, violating the ethical duty to act in the patient’s best interest. Professionals should employ a decision-making framework that begins with a thorough, multi-faceted assessment of the adolescent’s physical, psychological, and social situation. This should be followed by open and honest communication with both the adolescent and their parents, establishing shared goals and a collaborative treatment plan. Regular reassessment and adaptation of the plan based on the adolescent’s progress and evolving needs are essential. Ethical considerations, including patient autonomy, beneficence, non-maleficence, and justice, should guide every step of the decision-making process.

Scenario Analysis: This scenario is professionally challenging because it requires balancing a patient’s right to privacy and autonomy with the clinician’s ethical and legal obligations to ensure the patient’s safety and well-being, especially when developmental concerns intersect with potential risks. The clinician must navigate the complexities of adolescent development, including the evolving capacity for decision-making and the importance of maintaining trust. Correct Approach Analysis: The best professional practice involves a nuanced approach that prioritizes open communication with the adolescent while also assessing their capacity and understanding of the risks and benefits of their choices. This includes a thorough developmental assessment to understand the adolescent’s cognitive and emotional maturity, their ability to comprehend information, and their capacity to make reasoned judgments. If the adolescent demonstrates sufficient capacity, their informed consent is paramount. However, if the assessment reveals a lack of capacity or a significant risk to their health or safety, the clinician must then engage in a process that may involve parental notification, guided by established ethical principles and relevant state laws regarding minor consent and mandatory reporting. This approach respects the adolescent’s developing autonomy while fulfilling the duty of care. Incorrect Approaches Analysis: One incorrect approach involves immediately disclosing the patient’s information to their parents without first assessing the adolescent’s capacity or exploring the reasons for their request for confidentiality. This violates the adolescent’s right to privacy and can erode trust, potentially leading to future avoidance of healthcare. It fails to acknowledge the evolving autonomy of adolescents and the legal frameworks that often grant them certain rights to confidentiality, especially concerning sensitive health information. Another incorrect approach is to solely rely on the adolescent’s stated desire for confidentiality without any attempt to understand the underlying reasons or to assess their capacity to make informed decisions about their health. While respecting confidentiality is crucial, a complete abdication of professional judgment in assessing risk or capacity is not ethically or legally sound. This approach neglects the clinician’s duty to ensure the patient’s safety and well-being, particularly when developmental factors might impair judgment or increase vulnerability. A third incorrect approach is to dismiss the adolescent’s concerns and proceed with a course of action without adequate exploration or communication. This demonstrates a lack of empathy and a failure to engage in shared decision-making, which is fundamental to adolescent-centered care. It overlooks the importance of building rapport and understanding the adolescent’s perspective, which is essential for effective treatment and long-term health outcomes. Professional Reasoning: Professionals should employ a decision-making framework that begins with a comprehensive assessment of the adolescent’s developmental stage and capacity for informed consent. This involves understanding their cognitive abilities, emotional maturity, and comprehension of the situation. Simultaneously, the clinician must consider the specific health issue, potential risks, and relevant legal and ethical guidelines governing adolescent healthcare and confidentiality. Open and honest communication with the adolescent is key, aiming to build trust and encourage disclosure. If capacity is present and risks are manageable, the adolescent’s autonomy should be respected. If capacity is lacking or significant risks are identified, a careful, stepwise approach involving parental engagement, guided by legal mandates and ethical considerations, is necessary.