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Should Parents Be Allowed to Withhold Lifesaving Treatment?

What should be done for children whose parents reject the idea of providing them with potentially life-saving medical treatment? In a recent article on Medscape, noted ethicist Arthur Caplan related the story of a 19-month-old Canadian infant who died of bacterial meningitis while his parents treated him with alternative remedies such as maple syrup, hot peppers, garlic, and horseradish. The parents elected not to take him to a medical doctor, even after a nurse acquaintance warned them of the severity of the child's condition. The parents were later found guilty of "failing to provide the necessaries of life."[1] This heartbreaking story spurred passionate debate among healthcare professionals.

Unsurprisingly, most of those responding felt strongly that a seriously ill child must be seen and treated by mainstream medical professionals regardless of the parents' beliefs. (Some quotes have been edited for clarity.)
A surgeon kicked things off:

This is a serious problem: people who ignore the results of decades of research and development. I have been advised that because I am a medical school graduate, I am a member of a conspiracy against the sick and injured. This is so sad when it results in the loss of a life. Use intelligence and discernment!

A pathologist linked this kind of behavior with more commonly condemned forms of child abuse:

Child abuse can be actions of commission or omission. An example of an action of commission is beating a child. An example of an action of omission is not seeking medical care when absolutely needed. This tragic case would be classified in the latter category (a fatal omission). Society has the moral obligation to protect children because
children cannot protect themselves.

A pediatrician advocated stronger legislation, asking, "Would it be reasonable as a society to amend the Constitution to state that children must not be denied life-saving care, regardless of the belief system of the parent?"

But a dermatologist questioned the feasibility of the plan, asking in return, "Do you mean to say the Constitution should be amended to require the federal government to fund 100% of the healthcare costs of children? How else will your proposal be realized?"

A pathologist who had been down this path offered a dose of reality:

More than 20 years ago, on behalf of our state medical association, I presented this issue to our legislative leadership. They were very empathetic but described the solid opposition within some of our faith-based community. This past session, the question again arose, and the corrective legislation again died. We need help, and perhaps different communication strategies, in presenting this issue to the public.

But some professionals saw valid options when it came to serious childhood illness. One physician wrote, "How about we each live our own life and make our own decisions? Life is full of difficult decisions."
But some professionals saw valid options when it came to serious childhood illness. One physician wrote, "How about we each live our own life and make our own decisions? Life is full of difficult decisions."

An internist shot back. "This is a free country, and adults are certainly free to believe any sort of nonsense they wish, but they do not have the right to inflict their stupidity on their helpless children." Continue Reading
A health administrator thought it was counterproductive to take a hard line against those who did not seek mainstream medicine:

It is not a good idea to force people to take their loved ones to a hospital. These parents care the most about their child. If some people don't believe in medicine, we need to improve trust with medicine and the trustworthiness of those who practice it.

But a pediatrician was not buying this line of reasoning:

If you were talking about taking a dog or cat to a veterinarian, I would agree with you. But when you are saying parents have the right to eschew allopathic medicine due to a religious or philosophic concern, then you are condoning child abuse.

A registered nurse saw dangers in modern medicine that many other professionals were likely to dismiss:

Centers for Disease Control and Prevention statistics claim that more than 400,000 hospital-caused deaths occur every year. Doctors, hospitals, pharmaceuticals, and the medical insurance industry have set themselves up to prosper by treating symptoms and diseases and not to work intensively with patients on preventing morbidity with lifestyle changes. We provide lip service to prevention, but our livelihood is about the fix.

The final word goes to a nurse practitioner who offered a unique view on the complexity of the issue:

There have been times when I have encountered such parental opposition in the treatment of premature babies. What often happens is the neonatologist gets a court order to administer a treatment that the parents have declined, such as a blood transfusion. We have often found that parents cannot actually approve the transfusion but are okay as long as someone else takes the decision out of their hands. The parents aren't upset but are actually relieved when this approach is used. Their baby receives what is needed and they remain in good standing with their faith.

The full discussion of the topic is available on Medscape.