Medical Ethics Case Study Douglas Diekema

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When a patient’s/family’s religious beliefs go against recommended medical treatment, it brings up an ethical issue. If the patient is a minor, this makes the case even more complex. In such a case, the parents would need to be evaluated to see if they were properly representing their child’s best interest. Depending on the child’s age, the child would need to be consulted to see if he/she meets the criteria of having the capacity to make his/her own medical decisions. Finally, the physician needs to be consulted to determine what his/her beliefs are on the case and under what circumstances would he be willing to perform the surgery. In pediatric cases, the parents/guardians are initially given the right to make decisions for their minor …show more content…

The best interest standard holds that the treatment that minimizes cost and risk to the child is in his/her best interest. This is often the standard that governs physician decision-making processes as it is intimately tied with the principle of non-maleficence or to do no harm. But, the issue that arises with the best interest standard is that it lacks the ability to take into account the parent’s values and beliefs. When a parent does not agree with the recommendation of the physician, they are often deemed to not be acting in the child’s best interest. However, the threshold for this determination is very limited. Thus, Douglas Diekema, a pediatric bioethicist, suggests that instead of the best interest standard, physicians should apply the same standard that the State uses to prove cases of child neglect (2011). This standard is known as the harm principle. The harm principle disregards moral and value based differences and instead …show more content…

A child’s ability to have capacity is often loosely determined by the “rule of sevens” which states that children under the age of seven lacks capacity completely, children between seven and fourteen probably do not have capacity, and children greater than fourteen usually have capacity. Another consideration that needs to be taken into account when determining a minor’s ability to have capacity is if the child can be classified as an emancipated minor or as a mature minor. Emancipated minors, while the definition can vary slightly by state laws, are legally emancipated or separated from their parent/guardian, and have the right to consent for their own medical treatment as an adult. A mature minor, again the definition can vary by state law, is a minor that is 14 years or older, usually still under the care of his/her parents, that is deemed to be mature and intelligent enough to understand medical decisions. This mature minor is also able to take into account all benefits and risks for each of the treatment options presented and is able to make a rational treatment choice based on this information. The status of a mature minor is evoked either when a minor’s parent is not present at the

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