Junior doctors and the EC draft directive on working hours.

uncertainty has surrounded the issue of confidentiality. While most doctors will respect the confidentiality of those seeking contraceptive advice, the suspicion has remained that a few, because of their personal beliefs, would breach confidentiality in the case ofsomeone under 16. The difficulty for the young person lies in distinguishing between those doctors they can and cannot trust. The consequences of such a breach of confidentiality might well be devastating for young people, and the chances of their pursuing a complaint against the doctor would be minimal. The General Medical Council's guidelines on confidentiality do not deal specifically with young people and contraception but emphasise that information about a patient should be disclosed without consent only in the most exceptional circumstances.9 An explicit statement of what represents acceptable professional practice in the specific instance of a patient under 16 seeking contraception has, however, been lacking. The BMA, General Medical Services Committee, Brook Advisory Centres, Family Planning Association, and the Royal College of General Practitioners have now filled the gap. In a joint guidance note to be sent to all general practitioners next week they spell out in unequivocal terms that disregarding confidentiality in such circumstances is a serious breach of professional ethics. What is now required is a communications strategy so that young people will know that they can put their trust in doctors irrespective of whether they work in general practice, family planning clinics, or Brook Advisory Centres. Although progress is being made in medical confidentiality, a more sinister threat has arisen in the form of intimidation of those attending contraceptive services for young people. Premises have been picketed, and there have been threats to photograph those attending. This repulsive practice started in Belfast with the opening of a Brook Advisory Centre in September 1992 and now occurs in several cities across Britain. Such intimidation of young people seeking medical help is unacceptable in a civilised society and must not be allowed to succeed. GABRIEL SCALLY Regional director of public health South East Thames Regional Health Authority, Bexhill-on-Sea, Sussex TN39 3NQ