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Failure to Provide Adequate Palliative Care May Be Medical Neglect
Journal article   Open access   Peer reviewed

Failure to Provide Adequate Palliative Care May Be Medical Neglect

Carly Levy, Kristin S Weeks, Rebecca J Benson, Jonathan M Miller, Jennifer Higgins, Stephanie Anne Deutsch and John D Lantos
Pediatrics (Evanston), Vol.144(4), e20183939
10/2019
DOI: 10.1542/peds.2018-3939
PMID: 31484675
url
https://doi.org/10.1542/peds.2018-3939View
Published (Version of record) Open Access

Abstract

Doctors are required to notify Child Protective Services (CPS) if parents do not provide appropriate medical care for their children. But criteria for reporting medical neglect are vague. Which treatments properly fall within the realm of shared decision-making in which parents can decide whether to accept doctors' recommendations? Which treatments are so clearly in the child's interest that it would be neglectful to refuse them? When to report medical neglect concerns to CPS may be controversial. It would seem inhumane to allow a child to suffer because of parental refusal to administer proper analgesia. In this ethics rounds, we present a case of an adolescent with chronic pain who is terminally ill. Her parents were not adherent to recommended analgesia regimens. Her palliative care team had to decide whether to report the case to CPS.
Adolescent Analgesics, Opioid - therapeutic use Cancer Pain - drug therapy Child Abuse Child Protective Services Female Hospices Humans Medication Adherence Palliative Care - ethics Parents Personal Autonomy Self Administration - ethics Terminally Ill

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