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What about confidentiality when 16-year-old may be 'runaway'?

Recently a 16-year-old girl and a 40-year-old man who are living together registered with our practice. We are worried she is a runaway and are not sure what, if anything, we must do. Can you advise us?

The first concern is whether the young woman is living with the man voluntarily and whether she is at risk of serious harm, in which case you may be permitted to breach confidence. Similarly, if there is an overwhelming public interest or legal justification you may be permitted to breach confidence. Otherwise your two new patients have a right to complete confidentiality.

If you believe the couple are 'runaways' then you must consider the safety of both patients who could be at risk from an angry and vengeful family.

It should be possible to check in a sensitive manner with the young woman, on her own, that she is living with the man willingly and that there is no cause for concern. You must reassure her that you will treat all information in complete confidence.

Assuming the girl is living with the man willingly, her parents may in fact know and approve. In any case at the age of 16 a young woman may choose to leave home and live with an older partner and is not obliged to seek parental permission, or indeed to let her parents know that she is leaving with this intention.

At 16 she may quite legally consent to sex with her partner and you have no right to breach her confidence in this respect.

The exception to this is that it is illegal

for a person in a position of trust ­ such as a teacher, a doctor or a carer ­ to have sex with a young person under the age of 18 who is in their care.

If the girl has run away and her parents do not know where she is, you could inform

her that the National Missing Persons

Helpline on 0500 700 700 offers a totally confidential service that would let her parents know she was safe without divulging her whereabouts.

If she were to be at risk at any stage in the future she will be reassured to know you have respected her confidence and are a trustworthy source of help and advice.

If the girl was under 16 the situation would be different.

Dr Christine Dewbury, Wessex LMCs

Neither Pulse nor Wessex LMCs can accept any legal liability in respect of the answers given. Readers should seek independent advice before acting on the information concerned.

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