Pemulis

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I'm just an (older) premed, but have recently come across an ethical dillema that I was hoping somebody here could help me out on.

A girl I work with has been telling me recently how sick her baby is. The child is a 3-month old girl, who hasn't been able to keep anything down for almost two weeks now. Every time she eats/drinks she pukes, and she is now very underweight. The girl was telling me how her Pediatrician told her to take the baby to a GI specialist, but the earliest appointment she can get is in about three weeks. She's upset about this, but seems completely resigned to the situation. When myself and a few other co-workers tried to tell her she should either, a) take the baby to an ER or b) call the doctor back and make sure they know the seriousness of the situation and that the baby needs to be seen soon, she just kind of changes the subject, saying stuff like, "I can't talk about this. It just makes me so upset to think about how sick my baby is." From what it sounds like, the kid goes through long periods without being able to hold down ANYTHING, and even as a non-parent, non-doctor, it seems like the possibility of dehydration is a real one (a number of my co-workers also expressed this concern). But this mother seems to react to any unpleasant situation with a pattern of avoidance.

What do all of you think about this? My initial reaction is that, however well-intentioned, this girl is neglecting her baby's needs, and possibly jeopardizing her long-term health, maybe even her life. I've been contemplating contacting social services in my state about it. But on the other hand, as an outsider, I don't know all of the details. I have no reason to believe that this girl doesn't genuinely love her child, even if she is a bit dysfunctional as a mother, and I would hate to possibly get a family broken apart. Beyond that, I don't have a lot of faith in social services in general; I worry that if they did decide something was wrong, the baby might end up in the foster system, with possibly worse consequences. Or that conversely they might take the baby away from its mother without good reason.

Please, please, weigh in on this. I just want to do what's best for this child.

Thanks,
Pemulis
 

fourthyearmed

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I wouldn't contact social services at this point as you haven't even seen the child. If the pediatrician had thought it was serious enough, they would have admitted the child immediately, not just refered it. Pediatricians tend to know about the long waits to get into specialists. Also parents tend to overreact/overestimate about their baby's spitting up and losing weight. I've seen parents who claim their baby is keeping down absolutely nothing and wasting away but then the child is positively pudgy. If I were you I would encourage the mom to call the pediatrician (or just return with the child) and inform him how long it will take to get a GI appointment. If the doctor is concerned, he will handle the situation and either admit the child to the hospital or get the child in with GI immediately. If he is not concerned, then there is no need for you to be either.
 
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Pemulis

Pemulis

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Thanks for the reply...this does make me feel a bit better about the whole thing. It's just hard because this girl will start talking about how sick her baby is, but then when you ask her for any factual information (i.e. did you explain this to your pediatrician? when was the last time your child was able to eat and hold something down? etc.) she suddenly grows very evasive. Normally I wouldn't be prying, but there's just something suspicious about the whole thing. I've wondered too if this girl is just trying to get attention, which would be an entirely separate f--d up scenario. I just hope that her ped does have some idea of what the situation is and knows what he/she is talking about.

Thanks again.
 

kas23

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I agree with fourthyearmed. You haven't even seen this child. With no examination, you really can't make any meaningful diagnosis.

And people are crazy. Either she is completely overreacting, making crap up because she wants attention (overwhelmed single mother?), or (and I say this with all seriousness) the child doesn't even exist. Just wait until you do your psych rotation, you'll see what I mean. Who knows nowadays?
 

bigfrank

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Pemulis said:
I just want to do what's best for this child.

Thanks,
Pemulis
Then I would strongly encourage you to talk to someone in social services, a pediatrician, etc. where you live. Please don't make any decisions regarding another person's life/well being from an anonymous internet forum.
 

14022

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I truly mean no offense by this but I am trying to put this into perspective. I would think a licensed pediatrician would know more about what would be best for the child (medically) than either you, me, or the mother. The mother is following her doctor's advice. If you called social services and explained the situation, I think they would put this towards the bottom of the list of priorities of cases to investigate. They deal with pretty horrific cases of abuse and neglect on a daily basis. A report from a premed student with no medical training claiming a mother is neglecting her child by not insisting that her doctor take more aggressive action in the care of his/her patient would probably not be a major concern for them.

Now, if she fails to follow-up with the GI doctor, then that is a different story because then she is failing to follow the advice of a medical professional regarding the well-being of the child.

I admire your concern and your initiative. It will serve you very well in your future profession. However, in this case it may be worthwhile to watch and wait before acting.