A growing number of adolescents do not have a supportive and trusting relationship with an adult in a birth, foster, adoptive, or chosen family. Yet like all adolescents they need routine and sometimes specialized health care. This book is a collection of essays, case studies, and guidelines that describe the demographic, philosophical, medical, legal, and developmental framework in which these youth and health care staff confront medical decision making. The authors address questions of consent, confidentiality, access to care, and the right to refuse or demand care, emphasizing the real-world experience of adolescents as they struggle to overcome the challenges of being alone.