When Medical Care and Parents Collide-Parents Who Refuse Testing and or Treatment for Children
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TREATMENT APPROACH
When Medical Care and Parents Collide-Parents Who Refuse Testing and or Treatment for Children Lori D. Frasier 1,2
&
Nicole Smith 3 & Kathryn Crowell 1,3
# Springer Nature Switzerland AG 2019
Abstract Medical Neglect is a challenging diagnosis. Physicians and parents may clash over what they both perceive to be in the best interest of the child. Cultural, religious, financial, or philosophical differences between the health care providers and families can be difficult to negotiate. This paper reviews the definition of medical neglect and describes barriers that can prevent families from following medical recommendations for their child. Involvement of statutory authorities to intervene in cases of medical neglect may be helpful, but also may result in increased friction between parents and the health system, often without a satisfactory outcome for the child. Recognizing and then overcoming such barriers, as well as improving communication can help the family to begin to cooperate with medical recommendations. The paper will present an approach to families, parameters for reporting when all other options have failed, and the child remains at risk for harm due to the failure of the parent or caregiver to follow medical advice. The ultimate goal of any intervention is to ensure that children can achieve their full potential, in a nurturing and caring environment. Keywords Neglect . Medical neglect . Child abuse
The provision of medical care is based upon the premise that the health and well-being is desired by the recipient of that care. Medicine has advanced to the state where many diseases and conditions that were once considered fatal or lifechanging can now be treated, and even prevented. The return to health and the prevention of disease is a considered a reason to celebrate the state of modern medicine. Physicians enter practice with this ideal and spend many years in the acquisition of skills and knowledge to this end. The social expectation is that patients have a high regard for that knowledge and those skills. The contract between physician and patient has been considered sacred for millennia.
* Lori D. Frasier [email protected] 1
Department of Pediatrics, Penn State Children’s Hospital, Penn State Hershey College of Medicine, Hershey, PA, USA
2
Penn State Hershey Medical Center, Center for the Protection of Children, 500 University Drive, Hershey, PA 17033, USA
3
Penn State Milton S. Hershey Medical Center, Penn State Children’s Hospital, Penn State Hershey College of Medicine, Hershey, PA, USA
In pediatrics and specialties where the care of children is the focus, the parent or guardian traditionally has the right to make decisions in the best interest of their child. The majority of those interactions between parents, child and health care provider conform to the expectations of both the provider and the recipient of care. When the parental decision has little consequence to the health of the child and is considered within the right of the parents to choose,
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