Treatment and patient data about a minor

When treating a minor patient, their opinion must be taken into account whenever possible considering the minor’s age and level of development. No fixed age limits are defined in the legislation; instead, the decision must always be made on a case-by-case basis. A doctor (or other health care professional) decides whether, considering the minor’s age and level of development, the minor has the capacity to decide on the care in question themselves. This decision cannot be appealed against. In practice, a 12-year-old must be heard, and their opinion must be taken into account; the right to independent decision-making is determined by a health care professional (Act on the Status and Rights of Patients, Mental Health Act, section 24).

A minor who is capable of deciding on their own care is treated in cooperation with them, and they also have the right to refuse treatment. A self-determining minor decides themselves on the disclosure of the patient data in question and may also prohibit information from being given to their guardians (but cannot prohibit the filing of a child welfare notification).

If a minor is, on the basis of their age and level of development, not capable of deciding on their care, they must be treated in cooperation with their parents or guardian. In such cases, the parents have the right to receive their child’s patient data.

Parents or guardians do not have the right to prohibit treatment that is necessary to ward off a threat to the life or health of the minor patient (Act on the Status and Rights of Patients, section 9 subsection 3). On this basis, a parent or guardian also cannot prohibit the disclosure of the child’s patient data from the national Patient Data Repository.

A child’s data in the MyKanta service

A minor can view their own health records and electronic prescriptions in MyKanta if they have their own online banking codes, a mobile certificate or an electronic identity card for identification.

Recording an assessment of a minor’s decision-making capacity in the patient data system started in Soite on 13th of November 2022. This means that guardians can view information in MyKanta about minors under their care who have used Soite’s health care services. A health care professional cannot retrospectively record entries about a minor’s decision-making capacity and the disclosure of information to guardians in medical records or prescriptions that were created before the functionality was introduced on the 13th of November 2022.

A child or adolescent of any age may permit or prohibit the disclosure of their patient data to their guardians if a health care professional has assessed that they are capable of managing their own affair. The principle is that when an assessment finds that a minor does not have decision-making capacity, their treatment data is disclosed to their guardians in health care services or at a pharmacy and is also shown to them in MyKanta.

When it has been assessed that a minor is capable of deciding on their treatment, MyKanta will show the guardians the information that the minor wants their guardians to see. When a minor who has decision-making capacity, according to an assessment, prohibits the disclosure of information to their guardians, information related to managing a matter cannot be shown to the minor’s guardians in MyKanta and cannot be otherwise disclosed to them. Information covered by the prohibition is also not shown in MyKanta to a person with the right to receive information (such as a parent who is not the minor’s guardian).

The information about the minor’s decision-making capacity and about the disclosure of information to guardians is recorded in Soite’s patient data system. The information is linked to a specific visit/treatment period (service event) and/or a prescription/prescriptions, as the decision-making capacity is always assessed in relation to the matter being managed at the time.

If a minor has used health care services after the 13th of November 2022 and the information is not shown in MyKanta, the guardian may contact the unit where the minor used the services. Before contacting the unit, it is advisable to ask the minor whether the visibility of the information to the parents was discussed in health care services.

Further information on websites of the Social Insurance Institution of Finland Kela and the Finnish Institute for Health and Welfare THL: