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Childhood malignancies and decision making.

A R Holder1

  • 1Yale University School of Medicine, New Haven, Connecticut.

The Yale Journal of Biology and Medicine
|March 1, 1992
PubMed
Summary

Parents may face prosecution or have children removed if they fail to provide adequate medical care. Courts often uphold medical treatment, but complex ethical issues arise with life-prolonging therapies for child malignancies.

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Area of Science:

  • Medical Ethics
  • Pediatric Law
  • Child Welfare

Background:

  • Child neglect is legally defined by the failure to provide "adequate" medical care.
  • Adequate care is typically defined by licensed physicians, with courts rarely arbitrating specific medical approaches.
  • Parental refusal of medical care presents significant challenges, especially in cases of pediatric malignancies requiring long-term treatment.

Purpose of the Study:

  • To explore the legal and ethical considerations surrounding parental refusal of medical treatment for children.
  • To examine the complexities of court-ordered medical interventions for minors with serious illnesses.
  • To discuss the evolving capacity of adolescents in medical decision-making.

Main Methods:

  • Legal and ethical analysis of child neglect statutes and case law.
  • Review of principles governing parental rights versus state intervention in pediatric healthcare.
  • Examination of ethical dilemmas in pediatric oncology and end-of-life care decisions.

Main Results:

  • Courts generally prioritize a child's access to necessary medical care, sometimes overriding parental objections.
  • The long-term nature of cancer treatment complicates enforcement of court orders, raising concerns about parental flight.
  • Removing a child from the home for treatment imposes additional trauma on the already ill child.

Conclusions:

  • Ethical questions arise when considering court-ordered, life-prolonging treatments with severe side effects versus parental preferences for palliative care.
  • Parents retain the right to refuse experimental research for their children, irrespective of potential benefits.
  • Despite increasing recognition of adolescent autonomy, courts are hesitant to permit minors to refuse life-saving medical interventions.
Keywords:
Legal ApproachProfessional Patient Relationship

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