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February 9, 1990

The Health Care Needs of Homeless and Runaway Youths

Author Affiliations

The Hastings Center Briarcliff Manor, NY

The Hastings Center Briarcliff Manor, NY

JAMA. 1990;263(6):811-812. doi:10.1001/jama.1990.03440060051019

To the Editor.—  There are few patient populations more vulnerable than runaway adolescents.1 Sexual and physical victimization, substance abuse, pregnancy, and human immunodeficiency virus infection (New York Times. October 8, 1989:A1) leave runaways in dire need of good medical care, not to mention psychosocial support. Yet the new report of the American Medical Association's Council on Scientific Affairs1 chronicles a dearth of guidance for clinicians on how to meet the special needs of an often abused and wary teenager, whose relationship to other supposedly caring adults has frayed so badly that the bond is broken.Extensive work in medical ethics offers concrete guidance to help fill the gap the Council decries and suggests a vision of how the clinician-runaway relationship might work. For decades, scholars have advocated dismantling the traditional medical paternalism that ignores patients' rights. The vision urged instead has been one of patient self-determination in