Wednesday, 10 August 2016

Rights of parents

Parents do have rights to make decisions for their children.
However, if the decisions of the parents compromise
the health or well-being of the child in a major way,
they do not longer have these rights to make these decisions.

There are a few critical issues in the above.
Who can decide what makes up a compromise of the health of the child in a major way?
Health professionals? Or are health professionals often wrong as well?
There are surely many grey areas but there are many clear cut areas too.

If a baby has a condition that requires treatment to save his or her life,
parents do not have a real choice. Parents do not have the right to deny
their children life saving treatments.

There are many diseases with treatments that are so much proven to be effective,
that if parents refuse these treatments for their children it would amount to sheer neglect.
Examples include antibiotics for meningitis, intravenous fluids for children who temporary cannot take food and fluids orally, proper therapy for babies with severe jaundice (yellow discoloration of the skin), life saving surgeries etc.

If a child has a potentially life threatening condition for which there are life saving therapies available, (e.g. a tumor or growth in his body) and the parents refuse the doctors to properly investigate, that may be deemed putting the child at unacceptable risks as well.

If the prognosis is poor and/or if the burden of therapy is extremely high, the "autonomy" of the parents becomes more and more important. Luckily in most cases we doctors search in all earnest honesty for the best solution for the child together with the parents.

I have encountered several times situations where parents do want to make dangerous decisions for their children. As a caring doctor, this is sometimes very hard to accept. Still we try to understand why the parents would make such decisions and often try to help them solve the problems leading to these bad decisions. But if all empathy and sympathetic counseling fail, it can be very frustrating. I have had parents of patients, after telling them that if their child would not get this therapy, there would be almost certain death, they reply that they do not mind. These things are hard to accept.

Surely, we docs, are humans with our own ideology and emotions. Life is not always easy. Among the most difficult situations, I encounter in my professional life are still these times when parents choose a (-n obviously) "bad" option for their children.

I love the children. I love my job. I love to help the parents of my patients. I am aware that sometimes my good intentions may have a wrong outcome, but I hope and pray that what I do is the best possible for all.

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