Failure to Provide Adequate Palliative Care May Be Medical Neglect.

Document Type

Article

Publication Date

10-2019

Identifier

DOI: 10.1542/peds.2018-3939

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.

Journal Title

Pediatrics

Volume

144

Issue

4

MeSH Keywords

Adolescent; Analgesics, Opioid; Cancer Pain; Child Abuse; Child Protective Services; Female; Hospices; Humans; Medication Adherence; Palliative Care; Parents; Personal Autonomy; Self Administration; Terminally Ill

Keywords

Adolescent; Analgesics, Opioid; Cancer Pain; Child Abuse; Child Protective Services; Female; Hospices; Humans; Medication Adherence; Palliative Care; Parents; Personal Autonomy; Self Administration; Terminally Ill

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