Ethics: Parents Refusing Treatment for Children

[MMiz]

What would you do if you were at the scene of a serious trauma and the patient's parent/guardian refuses medical treatment for their minor?

I'm in that situation, of sorts, and am conflicted on my path forward.

 

[firecoins]

What would you do if you were at the scene of a serious trauma and the patient's parent/guardian refuses medical treatment for their minor?

I'm in that situation, of sorts, and am conflicted on my path forward.

how do you know its the parent?

tell the cops whats up. Could be criminal actions to refuse treatment in such a situation.

 

[medic417]

Are they refusing all treatment or only one treatment?

 

[MMiz]

What if the parent refused treatment for a minor injury?

 

[MMiz]

Are they refusing all treatment or only one treatment?

Great question, and from what I gather it matters. I don't know at this point, and most likely I'll never know. Unfortunately this is a hypothetical situation that stemmed from something complete unrelated to EMS.

 

[medic417]

Great question, and from what I gather it matters. I don't know at this point, and most likely I'll never know. Unfortunately this is a hypothetical situation that stemmed from something complete unrelated to EMS.

It is a fine line legally. If it is a minor illness, injury I doubt any legal authority would remove the parents rights to refuse care. If it is a serious illness or injury possibly a court would rule against the parents if they were refusing all care. If they only refuse one procedure and there are other options the courts normally still side with the parents even when Doctors feel the alternatives are not as good.

 

[MidwestFF]

At least locally for all but the most minor injuries all it would take is the opinion of 2 public safety providers IE: 1 FF and 1 PD or 1 FF and 1 EMT etc that the care is reasonably required and they can take custody of the child in order to render aid then transfer the child's care to social services. If the injury is imminently hazardous to life and limb all it takes is one, but you will have a lot of explaining to do.

I have seen this explained to a reluctant parent once; they consented although begrudgingly so as not to have Child Protective Services involved.

 

[medic417]

At least locally for all but the most minor injuries all it would take is the opinion of 2 public safety providers IE: 1 FF and 1 PD or 1 FF and 1 EMT etc that the care is reasonably required and they can take custody of the child in order to render aid then transfer the child's care to social services. If the injury is imminently hazardous to life and limb all it takes is one, but you will have a lot of explaining to do.

I have seen this explained to a reluctant parent once; they consented although begrudgingly so as not to have Child Protective Services involved.

Wow can any one say law suit? I would own your community if my child had care I refused forced on them. Sorry If I were you I would only use that protocol as a very last resort for something very extreme. There are some very complex legal issues at play and based on your post I am afraid your service has not fully explored all of them.

 

[lightsandsirens5]

I'd say number one, make sure they are the parent.

If they were still refusing treatment after you trying to talk them into letting you provide care, call the cops.

 

[JPINFV]

At least locally for all but the most minor injuries all it would take is the opinion of 2 public safety providers IE: 1 FF and 1 PD or 1 FF and 1 EMT etc

Assuming that the FF and LEOs aren't medical providers (EMTs or above, and to be fair, I'm tempted to exclude all of EMS since there's too much of "ZOMG, everything is life threatening and everyone injured will die in the next 2 minutes if not treated with everything" in the training), who are they to see what is or is not reasonable medical care?

 

[Fox800]

In my system, parents are not allowed to refuse treatment for their children who present with life-threatening illnesses or injuries.

 

[medic417]

In my system, parents are not allowed to refuse treatment for their children who present with life-threatening illnesses or injuries.

Ka-ching. Man I see dollar signs in some parents future.

 

[Fox800]

Ka-ching. Man I see dollar signs in some parents future.

Hasn't been a problem yet. This is in a major metropolitan area.

 

[FLEMTP]

Ka-ching. Man I see dollar signs in some parents future.

You keep saying this... over and over.. sue sue sue lawsuit ...

can you provide any sort of a legal precedence that would suggest that a lawsuit would even have legal standing in a situation as described in the original post? or are you just spouting off because you live in fear of a lawyer and litigation?

 

[firecoins]

If a child has a life threatening injury, we will transport with or with out parents permission. Parent can refuse in the ED with the doctor. Let them sue me. I am more than happy to treat and transport first and let the lawyers figure it out afterwards than let the kid die and have it be my fault.

Anything less than life threatening, parent can do what they want.

 

[medic417]

You keep saying this... over and over.. sue sue sue lawsuit ...

can you provide any sort of a legal precedence that would suggest that a lawsuit would even have legal standing in a situation as described in the original post? or are you just spouting off because you live in fear of a lawyer and litigation?

I have seen first hand the results of medics that have ignored parents. No I do not live in fear. No I will not present the cases, they are easily found.

 

[firecoins]

I have seen first hand the results of medics that have ignored parents. No I do not live in fear. No I will not present the cases, they are easily found.

Why put foward the argument if you won't back it up? If they are easily found, you would present them.

 

[Eydawn]

This is indeed a hell of a grey zone. My personal feeling would be that you could only overrule parents if it is something that is obviously life-threatening (AKA: the FF/LEO also sees that the kid is actually in danger of dying).

If I were presented with this kind of situation, I would turf it to medical control and local law enforcement. I would also try persuading the parents as strongly as possible that their child is in imminent danger of death or permanent disability. If it is obvious that the care is being withheld as a form of abuse, it should be fairly easy to hold up your actions in court, especially if you've got LEO and an order from an MD to back you up.

Use judiciously. Do not over-use. Be veeery careful with how you approach the situation. Document the hell out of whatever decision you and your med control and your LEO end up making, whether you provide care or not.

I would agree that I would err on the side of letting the lawyers figure it out after I've taken care of the kid... a minor child (or compromised adult for that matter) is depending on the good judgment of the parent and if that judgment is obviously lacking, I'd say we have an ethical responsibility to the child.

Wendy
CO EMT-B

 

[MonkeySquasher]

If a child has a life threatening injury, we will transport with or with out parents permission. Parent can refuse in the ED with the doctor. Let them sue me. I am more than happy to treat and transport first and let the lawyers figure it out afterwards than let the kid die and have it be my fault.

Anything less than life threatening, parent can do what they want.

You'll be happy to know that, I believe, per NYS DOH you may treat a ped with life/limb threatening injury/illness regardless of parental consent. "Action is preferable to inaction". Call PD to override parental consent, or call OLMC to override parental consent (which may require PD, not sure).

And as always, document document document. haha

 

[Akulahawk]

In my system, parents are not allowed to refuse treatment for their children who present with life-threatening illnesses or injuries.

Ka-ching. Man I see dollar signs in some parents future.

Not to mention Ka-ching if the child presents with life-threatening injury or illness, the parents refuse care and the provider does nothing...

That's a situation where you're you can get sued for doing something or doing nothing.

Here, I'd call LE, explain the situation, and if the LEO agrees, there are several ways that could go, but they all result in the child being treated.