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Treatment decisions in paediatric dialysis: children's versus parental rights
N Gabbai1, H Rauch-Elnekave, M Spitz
1Paediatric Dialysis Unit, Western Galilee Hospital, Nahariya, Israel.
Insights
Ethical dilemmas arise in pediatric dialysis when parents refuse optimal treatment. This paper reviews children
Area of Science:
- Pediatric Nephrology
- Bioethics
- Medical Law
Background:
- Treatment decisions in pediatric dialysis present complex ethical challenges, particularly when parental preferences conflict with recommended medical interventions.
- Ensuring the best interests of children undergoing dialysis requires careful consideration of their rights and well-being.
Observation:
- Case studies highlight conflicts between children's rights to optimal treatment and parental autonomy in medical decision-making.
- Legal frameworks, including the UN Covenant on Children's Rights and Israel's Patients' Rights Law, are examined in the context of these conflicts.
Findings:
- Children's rights to receive optimal medical care can be challenged by parental decisions for non-optimal interventions in pediatric dialysis.
- Existing legal protections for patients' rights need to be effectively applied to safeguard the interests of children on dialysis.
Implications:
- Policy recommendations focus on establishing multidisciplinary committees to mediate treatment conflicts and advocate for children's needs.
- Integrating children's expressed desires with medical necessity is crucial for ethical and effective pediatric dialysis care.
- Strengthening advocacy for children's rights within healthcare systems is essential to ensure their best interests are prioritized.
Abstract:
Treatment decisions in Paediatric Dialysis are often fraught with ethical questions about how to serve the best interests of children on dialysis, especially when parents refuse recommended treatment and opt for non-optimal interventions. This paper reviews the issues of children's rights, as guaranteed in the United Nations Covenant on Children's Rights and the Israel's Patients' Rights Law, and presents several case vignettes where conflict between children's rights for optimal treatment and parental desires arose. The paper concludes with policy recommendations to assure that children's expressed desires and medical needs are met, including the establishment of multidisciplinary committees to address the needs of children on dialysis and their families.