Question: If a parent disagrees with the doctor about administering chemotherapy to their child, what is the best course of action for the parent to pursue for the safety and health of the child and to maintain the integrity of the family?
Answer: Talk with other family members to determine if there are any differences of opinions. If there are differences within the family go to other trusted authority figures (Parents, grandparents, extended family members) and try to address the differences. Usually the problem is that the individuals involved have no previous experience with the particular issue. If the above doesn’t work go to trusted persons for mediation such as social workers, family counselors, or clergy.
Ask for a second opinion. Ask what the reasonable chance is for an expected good outcome. Most hospitals have bioethics committees to refer these situations to and individuals and families may ask for a consultation with the bioethics committee. Seek for resolutions to the differences rather than escalating to conflict. When the Medical practitioners and the patient’s family have diametrically opposed desires the bioethics committee can play a vital role in helping to determine which side should weigh heaviest. Circumstances such as age of the child, religious values and beliefs and differing goals can be evaluated.
The medical practitioner should provide an expected outcome and prognosis with planned treatment course. For instance if the expected outcome is less than a month it is a reasonable presumption to defer to the family for the decision on whether or not to proceed with the outlined plan of care. Only when there is a good reason such as psychosis, or behavior that a majority of persons would recognize as unacceptable should action be taken to remove custody of the child from the family and or sever legal ties to the parent/s.
When a child is old enough to be making decisions for themselves they should be given the opportunity to talk with someone outside of the presence of their parents – as it is unknown how much the parents are pressuring the child to make decisions against their own will. This person can be clergy, or a trusted adult such as a counselor, and should preferably be someone the child already knows and trusts.
Taking matters to court should be the last resort. Usually hospitals would rather not get involved in such disputes. This always expensive and both sides focus on “winning” rather than the patient.
In review: If you have questions regarding rights to make medical decisions and what the best course of action would be for yourself or your loved one seek help from family members, a social worker, clergy, or a family counselor. If issues remain unresolved seek a second medical opinion, ask to change doctors or hospitals that may be more open to the approach for care that you prefer to use. You can ask for a review from the Bioethics committee. When these measures do not result in a satisfactory outcome seek advice from an attorney who specializes in healthcare and or bioethics in the area where you live as laws differ from state to state.
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