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…
as they often hold the child’s best interest.
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…
focuses specifically on children and if they are at significant risk due to their parents’ decisions. Following this standard, instead of the best interest standard, providers would better be able to detect cases of medical neglect. Nevertheless, there is the still the issue of defining how to establish a level of harm that constitutes neglect by a parent/guardian. Depending on the results of this evaluation, if the parents are unable to act in the child’s best interest or is determined to be harming the child by their decision, the substituted judgment would move from the parents to a third party, possibly a guardian appointed by the courts. While the best interest standard/harm principle are important to consider in a pediatric ethics case when a child is deemed to have no capacity, additional principles need to be considered when a child is older and can possibly have capacity or limited capacity to make medical decision.
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
hospital or the minor disagrees with the parent’s decision. If a child is deemed a mature minor, his/her autonomy must be respected. Mature minors can supersede their parents when making medical judgments or if their decision matches that of their parents, the decision cannot be questioned as not in their “best interest”.
Today, there are so many legal dilemmas dominating trial for the courts to make a sound legal decision on whose right in a complicated situation. Despite the outcome of the case, the disagreement usually has a profound effect on the healthcare organization, and the industry as a whole. Many cases are arguments centered around if the issue is a legal or moral principle. Regardless what the situation maybe, the final decision is left to the courts to differentiate between the legality issues at hand opposed to justifying a case based on moral rules. According to Pozgar (2012), an ethical dilemma arises in situations where a choice must be made between unpleasant alternative. It can occur whenever a choice involves giving up something good and suffering something bad, no matter what course of action is taken (p. 367). In this paper, I will discuss cases that arose in the healthcare industry that have been tried and brought to justice by the United States court system.
Competent adults have the legal right to make decisions about their own health care without being challenged by a physician. However, in some instances, those same competent adults cannot make medical decisions for their children without the courts stepping in and overriding the parents’ legal rights. One of the most challenging and complicated task as a parent is to make a medical decision about their child that could mean life or death (The Canadian Bar Association, 2012).
In the book The Right to Die by Elaine Landau a story is shared of a young boy. The kids name is Juan and he was seventeen years of age, he had a terrible tumor that had to be operated on. The first surgery he had went well, but dismally the tumor came back again. Subsequently after the first surgery Juan was weak and almost died. The doctor and parents decided that he needed another surgery, however, Juan disagreed. He wanted to live the last few months of his life without pain, he wanted to go enjoy time at school and with friends. Instead his parents forced him into surgery and sadly died three weeks after surgery. The fact of the matter is that minors have a voice too, and it needs to be understood. Exactly like the Right to Die, some want the option to use it and others do not, but as long as it is available terminally ill patients feel more welcoming to the thought of death (Landau
A. A. The "Best Possible Child" Journal of Medical Ethics 33.5 (2007): 279-283. Web.
How can a child make the decision for the life of another child by themselves? In this paper I will outline the mental, physical, and safety issues of minors (age 18 and under) having an abortion and why it is so important that they need to get parental consent before making this life long decision.
Second, to ensure that parental rights are enforced; minors should need parental consent to obtain an abortion (Earll). Parents are legally responsible for the well-being of their children. They are responsible for giving th...
...dical emergency where there is not time to wait for court overruling, the staff is not legally obligated to obtain parental permission; in this case two consultants should make an entry in the patient’s chart that procedure or transfusion was necessary to save the patient’s life. As a consequence and overruling from the court system, the state withdraws parental decision in order to protect and promote health of the child (Effa-Heap, 2009).
Businesses across the world, including the United States, have a code of ethics statement within their business to stay professional, attract consumers, and stay away from the legal department. A code of ethics is a statement that explains the values and mission statement that goes along with their career. For instance, medical, business, social workers, and etc. have different mission statements and values for their consumers. During this essay, I’ll explain the medical code of ethics, how has the ethical code impacted myself, positively impacted my future company, job or society, lack of morals, my own professional code of ethics and life examples within the American Medical Associations Code of Ethics.
The word ethics is derived from the Greek word ‘ethos’ meaning character or conduct. It is typically used interchangeably with word moral which is derived from the Latin word ‘moves’ which means customs or habits. Ethics refers to conduct, character and motivations involved in moral acts. Ethics are not imposed by a profession, by law but by moral obligation. It is unwritten code of conduct that encompasses both professional conduct and judgement. Ethics helps support autonomy and self-determination, protect the vulnerable and promotes the welfare and equality of human beings. An ethical dentist- patient relationship is based on trust, honesty, confidentiality, privacy and the quality of care.1
Physician-assisted suicide refers to the physician acting indirectly in the death of the patient -- providing the means for death. The ethics of PAS is a continually debated topic. The range of arguments in support and opposition of PAS are vast. Justice, compassion, the moral irrelevance of the difference between killing and letting die, individual liberty are many arguments for PAS. The distinction between killing and letting die, sanctity of life, "do no harm" principle of medicine, and the potential for abuse are some of the arguments in favor of making PAS illegal. However, self-determination, and ultimately respect for autonomy are relied on heavily as principle arguments in the PAS issue.
Neonatal resuscitation is intervention after a baby is born to strengthen it’s breathe or to boost its heartbeat. Approximately 10% of neonates require some assistance to begin breathing at birth, but only 1% require serious resuscitative measures. Informed consent regarding neonatal resuscitation is a constant ethical debate. This discourse ordinarily occurs between doctors and parents; parents often feel that the decision has been made for them, believing that they were not fully informed of any consequences that may occur before making their final action plan, or thinking that their opinion was not taken seriously; however, doctors see the procedure in a different light, that the parents can’t choose the best option for the child regardless of counseling, or performing as the parents wished but believing that the result could have differed if the parents had known all the effects that it will have further down the line, or convinced that they would have made a better
Macklin R. (2003). Applying the Four Principles, Journal of Medical Ethics; 29: p.275-280 doi:10.1136/jme.29.5.275.retrieved from http:// jme.bmj.com/content/29/5/275.full
The goal is to prevent substantial harm to the parents and the child. There should not be discrimination
Advocates of this issue believe that minors should have the right to be in charge of their medical decisions. Dr. Eric Kodish believes that decisions made by teenagers on the older side who are able to make a righteous decision should be carried out. “I think the ethics of modern American life suggest that if people have the capacity to make a decision, they should be free to refuse treatment” (Shute 1). Advocates of minors being able to make their own medical decisions believe that if the minor shows enough maturity understanding of their desired action, then it should be respected and carried out. Dr. Eric Kodish uses what he calls “The Rule of 7s” to determine when a child should be allowed to make the decision.
The idea of “the child” is constantly evolving, and children appear to be maturing more rapidly each year. As a response, laws pertaining to minors have had to keep up with these social changes. In the health care context, the competency of children is constantly scrutinized and challenged. Accordingly, reforms to past laws that deemed minors lacked decisional capacity have resulted in the “mature minor” doctrine. Although this doctrine allows minors a degree of independence in the decision-making process it maintains many grey areas. The age of consent is inconsistent across provinces and territories, and the guidelines used to assess competence are vague and sometimes arbitrary. With such inconsistency in the measuring of adolescent competence, it brings me to question the competence granted freely to adults. To rightfully judge competence there must be a prototype, something that I and others can form a explicit definition around. With what I have collected, since individuals gain decision-making autonomy when they reach the age of consent, than the defining characteristic of comp...