A growing number of adolescents do not have a supportive and trusting relationship with an adult in a birth, foster, adoptive, or chosen family. Through a variety of circumstances, they are literally or functionally ‘alone’. 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 demography, 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. Throughout the emphasis is on the real-world experience of adolescents as they struggle to overcome the challenges of being alone. Professionals who work with these adolescents cannot replace their absent or disinterested families but can fulfill the critical role of trusted adult advisor.