A 16-year-old patient reveals abuse by a parent during physiotherapy. The patient asks you not to tell anyone. What should you do?

• A. Respect autonomy but tell her she should report this.
• B. If afraid of repercussions, tell her there is help and healthcare can remain confidential for minors.
• C. If abuse is confirmed, do nothing and keep confidentiality.
• D. Immediately tell the parent and remove the patient from care.

Answer: (A)

When a minor reveals abuse, safeguarding her safety takes precedence over keeping the information confidential. You acknowledge her desire for privacy, but you are obligated to act to protect her. The best approach is to explain that you must report suspected abuse to the appropriate child protection authorities, and you should support her through that process. Encourage her to report the abuse herself if she wishes, and offer to help with the steps, such as providing information about how to contact services and accompanying her if needed. Do not promise confidentiality in a situation where a minor is at risk, and you should not disclose the disclosure to the parent or take actions that would bypass proper protective procedures.