Christian Scientist scenario

[Nameless]

Note: This is a hypothetical worst-case scenario I'm throwing out here. This never happened to me, and I hope this never happens to anyone. I just wanna know how the rest of you guys'd handle this!

Scenario:

You and your partner get called to a "sick person" in a fairly decent suburban neighborhood. The only information dispatch has given you is the patient is an 8-year-old male. The scene is secure. You arrive on scene and find out the neighbor has called. The neighbor, an elderly woman, tells you she was outside working in the garden in the afternoon and saw little Timmy (the patient) step outside. Not 5 seconds after he has been outside, he collapsed. She immediately called 911. You see the parents out in the back hovering over the boy, and head for the backyard. The father immediately orders you to leave. He states he and his wife and Timothy are Christian Scientists and they do not want you doing anything. You catch a glimpse of Timmy. You do not see notable chest rise and fall, nor do you see nasal flaring. He appears lifeless and is very pale. Cyanosis can be seen around the lips. He does not respond to his father's yelling. Your partner steps aside and attempts to call PD. Dispatch says there are no available units in the area. You attempt to get a signature from the father to not transport, and the father refuses to sign anything.

What would you do?

 

[STXmedic]

Get the neighbor to sign as a witness and document. Would probably get a supervisor out there, too. Sucks for the kid, but people have a right to have their beliefs respected.

 

[Handsome Robb]

You request LE emergent.

An unresponsive, possible pediatric arrest will free up cops faster than you can blink your eyes.

Reason with the father, ask him I you can at least check to see if his son is alive. Let him know what you think is happening. Most parents will realize you're serious and change their attitude. "Sir your son is potentially dying, please let me at least check his pulse and if he's got one just breath for him until we can work something out."

Yea they can have their beliefs respected but at what point is it abuse and child endangerment? What lead up to this? If it's abuse the father doesn't have any say anyways.

 

[STXmedic]

If it's abuse the father doesn't have any say anyways.

Very valid point.

 

[wanderingmedic]

1) I would not have even attempted to obtain a sig, this kiddo is going to receive treatment like it or not.

2) I would immediately get in contact with medical control and get permission to protective custody the child. I would reiterate the situation to dispatch and articulate that a non response from PD is unacceptable. From what it sounds my partner and I would be in physical danger from the "parents" if we attempted to treat, so PD needs to be put en route. When police hear kiddos are in trouble they come running just as fast. PD could also potentially PC the pt.

3) How do I know those are actually that pt's parents and can legally decline treatment? Chances are they are not carrying proper Id for them and the child, as well as a birth cert to prove they are parents...sooooo for all I know these are crazy people trying to harm this child.

4) I am a PT ADVOCATE, not a parent's rights advocate. If I think this pt needs my help I will do everything in my power to advocate for their treatment regardless of what their parent's beliefs dictate.

This happens in Phoenix because of the JW population. When I was last there PHX children's will PC the child and obtain a court order to transfer custody regarding treatment to a court appointed advocate.

 

[wowmulewow]

Have the neighbor sign as witness for refusal to sign and leave the premises (afterall, the father told you to leave). LEOs cannot forcibly remove the parents from their child or their property. At this point, you would be trespassing. As for abuse or endangerment, it is neither. A minor child in the eyes of the law does not have the ability to make an informed decision or have any legal presumptions in the matter. The best you can do is respect the family's wishes/ beliefs. As with most sudden pediatric deaths, there will be a LE Investigation, which would involve an autopsy, and rule out or support abuse, endangerment, medical history, etc.

 

[VFlutter]

4) I am a PT ADVOCATE, not a parent's rights advocate. If I think this pt needs my help I will do everything in my power to advocate for their treatment regardless of what their parent's beliefs dictate.

To play the Devil's advocate, what makes you think that you know what is best for the patient more than the parents? Are you not imposing your own beliefs on the situation? What if you walk up to the kid, who is in obvious distress, and he says "Don't touch me, I don't want to go to Hell for taking medicine". Are you still going to force treatment?

It is a complicated situation, and I am not saying nothing should be done, but your whole approach is a little brash. You are entering a situation where you are not wanted and may not have legal authority. Like it or not you can not just storm in, treat the patient, and then have the parents arrested for interfering.

 

[wowmulewow]

3) How do I know those are actually that pt's parents and can legally decline treatment? Chances are they are not carrying proper Id for them and the child, as well as a birth cert to prove they are parents...sooooo for all I know these are crazy people trying to harm this child.

To play Devil's Advocate, Do you carry your minor child's birth certificate with you when you go to the grocery store, the park, or the movies? Probably not. Plus we have to remember the neighbor, she knows the child and the parents. Granted, the Neighbor is not a State Issued ID card, but the neighbor will be able to identify the parents and the child as a family. Also, they were at their house, so they probably do have proper ID somewhere inside. Also, we have to remember this is occuring on private property, if the property owner orders you to vacate, you must do so. LE would more than likely not be able to PC the child in this amount of time, especially over the parents claim of CS. PC'ing a child because of his parents beliefs (which could be the child's as well) steps into the area of personal freedoms and liberties that we are granted as Americans.

Im not saying you should let the child lay there dying, but the law does somewhat tie our hands on this one. Now what about determining whether the parents are capable of making the informed decision of their child? Are they possibly intoxicated, under the influence of an altering substance, or have any faculty that may prevent their decision making capability???

 

[MonkeyArrow]

1) This happens in Phoenix because of the JW population. When I was last there PHX children's will PC the child and obtain a court order to transfer custody regarding treatment to a court appointed advocate.

Do the courts really grant PC (and subsequent treatment) all that often over the parent's wishes? I would think that the separation of State and Church with the 1st and all that other good stuff would prevent the courts from restricting the parent's religious wishes. I understand that hospitals have whole ethics panels and protocols for dealing with such stuff but would it happen all in time to save little Timmy "by the books"? Probably not.

 

[medicsb]

This is a classic ethics question. General consensus is to treat the kid. Nonetheless, you should contact medical command ASAP and await LEO arrival to remove the parents.

However there is not always one right answer when it comes to ethics, so this could be argued more than one way.

Questions like this is why college level ethics must be taught to all healthcare providers.

 

[RebelAngel]

Hum. Tough sitution.

What is the law for medical neglect in your state?

Sent from my XT557 using Tapatalk 2

 

[mycrofft]

I think local (state) laws and maybe even federal cases might need to be reviewed about legality.

In the instance, the child is apparently dead and that requires law enforcement. Tell dispatch you have a dead kid and the family won't let you approach.

PS: treatment whether the family wants it or not? And what if Dad or Mom smacks you with a hammer or stands in your way and you push them?

 

[PotatoMedic]

I kinda wish we had a lawyer on here... oh wait.

 

[wowmulewow]

If you stand in the way of the family, not only are you still trespassing, but now you have committed assault, intimidation, disorderly conduct, etc. You also are putting yourself and your partner at risk for injury from emotional parents, let alone a possible civil suit against you and your agency. To me this is somewhat like a situation where you are presented with an invalid DNR, the family wants you to honor it, but because it's expired or missing a signature, it's no longer a legal document. except in this circumstance you cannt treat the minor without parental consent. It's all a legality issue to be sorted out by LE and the courts, post incident. No matter what we do in this particular situation, it opens us to possible civil and criminal suits.

 

[Brevi]

Religion and Medicine don't always play together so nicely.

Under the doctrine of 'parens patriae' the state generally will not allow a child's health to be seriously jeopardized because of the parent's own limitations or convictions.

"The right to practice religion freely does not include the liberty to expose... a child... to ill health or death. Parents may be free to become martyrs themselves. But it does not follow that they are free ... to make martyrs of their children..." Prince v Massachusetts

A parent does not have the authority to forbid saving their child's life. If it were me in this scenario, I would request PD, provide care and deal with the fall out after, but that's just me.

 

[TheLocalMedic]

Religion and Medicine don't always play together so nicely.

Under the doctrine of 'parens patriae' the state generally will not allow a child's health to be seriously jeopardized because of the parent's own limitations or convictions.

"The right to practice religion freely does not include the liberty to expose... a child... to ill health or death. Parents may be free to become martyrs themselves. But it does not follow that they are free ... to make martyrs of their children..." Prince v Massachusetts

A parent does not have the authority to forbid saving their child's life. If it were me in this scenario, I would request PD, provide care and deal with the fall out after, but that's just me.

Bingo. I was about to unleash a tirade against everyone who was advocating to just shrug and walk away. ARE YOU SERIOUS??? If a child is in danger or dying, there is nothing that anyone can say that can legally prevent you from helping them. And no amount of signatures or paperwork will save your behind from the litigation that will surely follow if you walk away and allow a child to die.

For all I care, the parents can tell me they belong to the Flying Spaghetti Monster Cult and they believe their dying son will turn into meatballs. Whatever the parents say, they cannot prevent their child from receiving life saving emergency treatment.

The only thing that would hold me back is if I was in immediate physical danger, like if the parents had a gun. Otherwise that kid is mine.

 

[RebelAngel]

I was searching Google for information about parents refusing treatment for minors in emergency situations and found this thread from here:
http://www.emtlife.com/archive/index.php/t-18352.html

I also bookmarked a few pages regarding laws in NYS, and will be asking the NYS Paramedics I know personally, my Captain, and my EMT course instructor.

 

[medicsb]

http://pediatrics.aappublications.org/content/128/2/427.full

From the American Academy of Pediatrics

Policy Statement: Consent for Emergency Medical Services for Children and Adolescents

Committee on Pediatric Emergency Medicine and Committee on Bioethics

"When a legal guardian refuses to consent to medical care or transport that is necessary and likely to prevent death, disability, or serious harm to the child, law enforcement officers may intervene under local and state child abuse and neglect laws..."

"When faced with a guardian who refuses to allow the provision of necessary medical care or transport of a child when it is necessary to save a child's life or prevent serious harm, it might be necessary to notify the police and enlist their assistance in placing the child in temporary protective custody..."

"...a medical professional should provide medical treatment without consent only when the child has a medical condition that poses a risk of death or serious harm, when immediate treatment is necessary to prevent that harm, and when only those treatments necessary to prevent the harm are provided."

 

[Rialaigh]

I cannot place a child in temporary protective custody. I would get a doctor on the phone and LEO's en route to me while exiting the property. I am not going on this property to treat this child if the parents don't want it and are threatening without LEO's legally placing the child in protective custody, which whether they can place a "dead" child in protective custody is probably another legal issue altogether as in this scenario.


A parent does have the authority to forbid saving a child's life. Numerous scenarios where children require surgery or blood transfusions for life extending/saving procedures and after the court of law has been brought into it the parents view stands legal in the eyes of the state.

 

[wanderingmedic]

A parent does have the authority to forbid saving a child's life. Numerous scenarios where children require surgery or blood transfusions for life extending/saving procedures and after the court of law has been brought into it the parents view stands legal in the eyes of the state.

Do you have any sources to cite? Evidence presented in this thread so far seems to discredit your statement.