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Updated: Feb 2, 2026

Assessing the Coherence of Parents' Short Narratives Regarding their Child Using the Five-Minute Speech Sample Procedure
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Child Abuse, Incarceration, and Decisions About Life-sustaining Treatment

Paul C Mann1, Elliott Mark Weiss2, Rebecca R Seltzer3,4

  • 1Division of Neonatology, Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, Georgia.

Pediatrics
|November 10, 2018
PubMed

Insights

When parents are legally unable to participate in their child's critical care, medical teams face ethical dilemmas. This case explores navigating complex decisions for infants needing intensive care without parental bedside involvement.

Area of Science:

  • Pediatric critical care ethics
  • Neonatal hypoxic-ischemic encephalopathy (HIE)
  • Shared decision-making in pediatrics

Background:

  • Parental presence is crucial for shared decision-making in pediatric critical care.
  • Legal issues can prevent parents from being present at the bedside.
  • This can complicate clinical decision-making for critically ill children.

Observation:

  • Presents a case of an infant with severe hypoxic-ischemic encephalopathy (HIE) at birth.
  • The infant's mother was incarcerated shortly after delivery, precluding her bedside presence.
  • The medical team faced challenges in determining the infant's best interests.

Findings:

  • Explores the clinical and legal challenges encountered by the medical team.
  • Highlights difficulties in deciding on appropriate therapies and their duration.
  • Examines the ethical considerations when parental involvement is restricted due to legal entanglements.

Implications:

  • Informs ethical frameworks for managing critically ill children with absent parents.
  • Provides insights into legal and clinical decision-making processes in challenging circumstances.
  • Stresses the importance of addressing ethical and legal complexities in neonatal intensive care settings.

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