imxpandanese

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Hello,

I was thinking about 2 different situations revolving around parental consent and how physicians are expected to respond. Assume child is under 10 and does not have decision making capacity.

1) Child diagnosed with acute lymphoma. Determined that if child does not get blood transfusion, child will die. Parents are Jehovah witnesses and refuse treatment -->
Normally, physician is expected to respect their religious beliefs bc forcing transfusion constitutes assault.

2) Child diagnosed with acute lymphoma. Determined that if child does not get cancer therapy, child will die. Parents are naturopaths / spiritualists and refuse treatment, opting instead for herbal supplements, bok choy extracts, and honey soaked rags -->
Normally, physician is professionally obligated to seek court order or intervene out of child's best interest. Historically, parents have been found guilty when the child has died from naturopathic treatment.

Can someone with experience chime in as to why the different outcomes? (Note: these were based on the case discussions I've read on the University of Washington Ethics page: U of W School of Medicine Bioethic Topics)
 

TelemarketingEnigma

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Your assessment for point one is false. I'm not sure about your acute lymphoma scenarios specifically, but the legal precedent for children generally indicates that if a child needs a blood transfusion and will die without it, physicians can give the transfusion even if parents refuse consent. A "mature" minor (think late teen) or an adult can refuse to consent themselves, which a physician must respect.
 
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bobeanie95

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Your assessment for point one is false. I'm not sure about your acute lymphoma scenarios specifically, but the legal precedent for children generally indicates that if a child needs a blood transfusion and will die without it, physicians can give the transfusion even if parents refuse consent. A "mature" minor (think late teen) or an adult can refuse to consent themselves, which a physician must respect.

Is this only in the case of blood transfusions, or does this apply to any medical procedure/protocol that has the potential to save a child's life?
 

TelemarketingEnigma

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Is this only in the case of blood transfusions, or does this apply to any medical procedure/protocol that has the potential to save a child's life?

I believe it applies as well to other procedures, but it would depend on the circumstances and other relevant precedents. Basically, parents cannot make martyrs of their children. This paper is blood products/anesthesia focused but has good background information on some of the rationale.
 
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Hello,

I was thinking about 2 different situations revolving around parental consent and how physicians are expected to respond. Assume child is under 10 and does not have decision making capacity.

1) Child diagnosed with acute lymphoma. Determined that if child does not get blood transfusion, child will die. Parents are Jehovah witnesses and refuse treatment -->
Normally, physician is expected to respect their religious beliefs bc forcing transfusion constitutes assault.

2) Child diagnosed with acute lymphoma. Determined that if child does not get cancer therapy, child will die. Parents are naturopaths / spiritualists and refuse treatment, opting instead for herbal supplements, bok choy extracts, and honey soaked rags -->
Normally, physician is professionally obligated to seek court order or intervene out of child's best interest. Historically, parents have been found guilty when the child has died from naturopathic treatment.

Can someone with experience chime in as to why the different outcomes? (Note: these were based on the case discussions I've read on the University of Washington Ethics page: U of W School of Medicine Bioethic Topics)

A court order would be sought (and obtained) in both cases.
 
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