[Should a minor, unattended by a parent, be given medical services? Use of an algorithm to critique the Israel Ministry of Health regulations].

Background: Parents are the natural custodians of their children, thus minors need parental approval to receive medical services. In February 2004, the Israel Ministry of Health issued a set of regulations titled "Visits of unaccompanied minors to primary care clinics", aimed at assisting primary care clinicians in their decision-making process on this sensitive issue. Aims: 1) To convert the above mentioned regulations into an algorithmic format in order to facilitate their use by community clinicians, and 2) To review and critique the regulations, using the process of algorithm conversion. Methods: The regulations were studied thoroughly. Three rounds of Delphi process for reaching consensus were used to create an algorithm, based on these regulations. The algorithm building process was used to critique the regulations. Results: The Israel Ministry of Health regulations, "Visits of unaccompanied minors to primary care clinics", were found to be long and complicated. The process of building the algorithm revealed several difficulties - certain concepts were not well defined, many exceptional situations were found and a large portion of the regulations was dedicated to reporting and record keeping. Converting the regulations into an algorithmic format simplified them and assisted in their review. Conclusions: Converting complex regulations into an algorithmic format can facilitate their daily use by community clinicians. Parts of the regulations for "Visits of unaccompanied minors to primary care clinics" are incompatible with present clinic routine and, therefore, difficult to implement.