Examination in smaller patients

Check out an article signed by Dr. Alan Skorkowski, CBR's legal counsel, about the age rating for exams and the need for companions.

Initially, it should be clarified that the Brazilian Civil Code, as regards the ability to perform acts of civil life in relation to age, includes the following classification: children under 16, if absolutely incapable, should be represented; minors between 16 and 18 years old, if relatively incapable, should be assisted to perform certain acts.
The Statute of the Child and Adolescent, in turn, considers children to be persons up to 12 years old incomplete, and adolescents between 12 and 18 years old, according to what is written in its article 2.
Based on the criteria described above, the Regional Medical Councils (CRMs) have advocated that in the medical care of a child - therefore, the person up to 12 years old incomplete -, the accompaniment of a legal guardian is necessary and, in the case of If you are a teenager - someone between 12 and 18 years old - you may be unaccompanied if you wish, and you are guaranteed the rights of autonomy and confidentiality (except in situations provided for by law and / or those that characterize risk of death to the patient or third parties).

CFM Opinion No. 25/13 gives some guidance on the issue:

• In case of urgency / emergency, care should be provided, taking care to ensure the highest possible safety to the patient. After this step, communicate with the responsible as soon as possible;
• In pre-adolescent patients, but under conditions of spontaneous attendance at the service, care may be provided and, at the same time, contact with the caregivers;
• Regarding adolescent patients, there is international consensus that between 12 and 18 years old, they already have their privacy guaranteed, especially if they are over 14 years and 11 months old, because in this situation they are already considered mature in terms of understanding and understanding. compliance with the guidelines received;
• In the range of 12 to 14 years and 11 months, the service can be provided and, if necessary, inform the responsible.

“The concept of mature adolescent, however, may, according to the professional's assessment, not be restricted to age only, since in the dynamism that characterizes this phase of development, maturation may suffer variation due to socio-environmental and personal influences. Finally, care must be taken that art. 74 of the Code of Medical Ethics, which prohibits the physician: 'Disclose professional secrecy related to an underage patient, including their parents or legal representatives, provided that the minor has discernment, unless non-disclosure may cause harm to the patient. '”Says Dr. Celso Murad, draftsman of the opinion.
Finally, in addition to the notes and guidelines presented so far, it is noteworthy that, in all cases, it is absolutely recommended that a companion be present in the room when the exam is performed.

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Written by

Thiago Braga

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