Doctors need to respect parents' authority

Dear Dr. Dobson: Our family physician wants to examine my 13-year-old son without my being in the room. That's OK with me, but I expect him to tell me what my boy says and what his medical condition is. That's where we disagree. He says he must keep their conversation confidential. Am I right to expect to be informed and involved?

Dear Reader: Teenagers are typically sensitive and modest about their bodies -- especially when their parents are around -- so I can understand the need for privacy during a physical exam. The larger issue here, however, is the physician's accountability to you as the mother, and at this point, I agree entirely with the position you have taken. Other parents have expressed similar concerns to me.

I'm reminded of a mother who told me that she took her 14-year-old daughter to their pediatrician for a routine physical exam. The mother was aware that her daughter was beginning to develop physically and might be sensitive to her being in the examining room with her. She offered to remain in the waiting room, but the girl objected.

"I don't want to go in there by myself," she said. "Please come with me." After arguing with her daughter for a moment, the mother agreed to accompany her to the examining room.

When the exam was over the doctor turned to the mother and criticized her for intruding. He said in front of the girl, "You know, you really had no business being in the examining room. It is time I related directly to your daughter. You should not even be aware of the care that I give her or the medication I prescribe. Nor should you know the things that are said between us. My care of your daughter should now be a private matter between her and me."

The girl had been going through a period of rebellion, and the mother felt her authority was weakened by the doctor's comments. It was as though he were saying, "Your day of supervision of your daughter has now passed. She should now make her own decisions." Fortunately, that mother was unwilling to do as she was told, and promptly found a new doctor. Good for her!

I have discussed this conversation with several pediatricians, and they have each agreed with the doctor in this case. They emphasized the importance of a youngster having someone to talk with in private. Perhaps, but I object to the autonomy demanded by the physician. Fourteen-year-old boys and girls are not grown, and their parents are still the best people to care for them and oversee their development. It is appropriate for a physician to have some private moments with a young patient, but he or she should never forget to whom accountability is owed.

Furthermore, if greater authority is to be granted to the doctor, the parent had better find out just what he or she believes about contraceptives for minors, premarital sex, spiritual matters and the like. Be careful whom you choose to trust with the body and the soul of your child. The pace of living is so frantic today that we have become dangerously willing to accept surrogate parenting from a variety of professionals who meander through our lives.

Dear Dr. Dobson: I really believe in giving children the freedom to do wrong as long as there isn't any danger involved. For example, I let my children curse and use swear words and don't see any harm in it. Do you agree?

Dear Reader: No. I would hope that parents wouldn't use that kind of language and certainly don't believe they should permit their children to do so. It is disrespectful, crude and unnecessary to talk like that.

Send your questions to Dr. James Dobson, c/o Focus on the Family, P.O. Box 444, Colorado Springs, Colo. 80903. Dobson is the chairman of the board for Focus on the Family.