Parental Refusal of Life-Saving Care for a Minor Child - Research Paper Example

? Ethical Decisions of Ethical Decisions Parental Refusal of Life-Saving Care fora Minor Child Introduction The principle of parental refusal of life-saving care for a minor child is one of the most recurrent in many hospitals across the world compared to other current ethical health care issues. This is because it involves decision making that requires consent of a person who cannot competently do so mainly because of age factor (Beauchamp and Childress, 2001). As such, such consent has to be sought from someone else, and in this case the parent. Due to the nature of this circumstance, various ethical issues usually tend to arise. The major ethical issues that usually arise include: autonomy, beneficence, non-maleficence, and justice. Minors are considered not be competent enough to consent to treatment. A proxy with parental responsibility is expected to make decisions which are deemed to be in the best interests of the minor especially in life-saving care (Gaudine, et al., 2011). However, if it is not deemed to be so, the decision made by the proxy can be overruled by the court. The court can also consent on the child’s behalf and can overrule the refusal by the parent to consent to life-saving care. This is evidenced by the overruling of cases over Jehovah’s Witnesses believers refusal to consent to life saving blood transfusion. Whereas this seems to be against certain ethical principles, they are deemed to be within these principles in some respect (Clark, Cott, and Drinka, 2007). It is against this background that this paper will seek to examine and evaluate how each of the four major ethical principles can be applied to this issue. Autonomy The autonomy principle is one of the guiding medical ethics principles that mean that patients have the right to choose what is done to their respective bodies or that of the people they have responsibility over (Clark, Cott, and Drinka, 2007). For minors, the parents decide for them. The question, however, arises on what happens when parents refuse to consent a life-saving care for a minor? In an event that doctors believe that the parents are not acting on the best interests of the child, they can go to court in order to try and convince the judge that the court should take temporary child custody and appoint a guardian so as to allow the life-saving treatment to be undertaken on the child (Gaudine et al, 2011). This is where the court consent applies on the child. In most cases, the parents who refuse life-saving care for a minor child usually do so for religious reasons as they refuse the fairly standard medical treatment. A good and most common example is that of the Jehovah Witness members refusing blood transfusion of their family members. Nonetheless, should parents allow the treatment of their children even when the treatment seems to be high-risk and complicated one? This ethical principle asks the question of whether the doctors should take the parents who think that the life-saving care is high-risk and complicated (Beauchamp and Childress, 2001). Beneficence This ethical principle states that whatever is done should, before all else, of benefit to the patient. The principle requires that those with the responsibility over the patient including the parent of minors and the doctors should take actions that benefit the patient, and not to the detriment of the patient (Clark, Cott, and Drinka, 2007). While obviously it appears that one cannot do anything that does not help the patient, people are sometimes tempted to do things, when asked by other physicians or families that are of no or of marginal benefit to patients. For example, doing a test or surgery that is unlikely to help the patient. In the case of parental refusal of life-saving care for a minor child, it raises the question of whether such a refusal is deemed to benefit the minor child or not. If such a refusal will benefit the child then the doctors may consider it. However, in most cases, parental refusal is usually contrary to doctors’ opinion. As such, the refusal may be seen not to benefit the child because it is formed against informed and professional view that overrides feelings and emotions (Beauchamp and Childress, 2001). Therefore, the doctors may take the parent to court in order to seek the overruling of the decision by the parent, if they believe that their recommendation will benefit the minor child and that the parental refusal would be detrimental to the child’s health. Non-Maleficence This ethical principle is based on the principle of “first do no harm” which cautions physicians to avoid harming their patients. Ideally, it is expected that a physician may not have any intention of harming the patient. However, reality shows that some treatments or tests do not probably help, in the long run. This ethical principle requires that the physician should first examine whether his treatments and tests will harm the patient if administered (Gaudine et al, 2011). Since a minor child might not be able to express or foresee the “harm”, the parent may do so on his or her behalf by refusing to treatment, especially in the case of life-saving care. Admittedly, some treatments and tests can harm the patient and cause more suffering and pain than failure to administer them. This principle therefore requires physicians to avoid such tests and treatments. Similarly, it allows the parents of a minor child to refuse treatment or tests that may harm the child more. For example, parent can refuse a consideration of giving a child with an advanced cancer a highly toxic drug that might treat cancer, but will definitely cause the child more suffering and pain. Therefore, this ethical principle calls for all considerations to be put in place especially in life-saving care to ensure that harm is avoided. Alternative treatments and tests with less harm should be sought to avoid doing harm (Clark, Cott, and Drinka, 2007). Justice The final major ethical principle that can be applied in the issue of parental refusal of life-saving care for a minor child is justice. This principle implies that physicians are obligated to treat each patient equally, irrespective of sex, insurance status, personality, race, and age among other dimensions that may contribute to injustice. In other words, this principle prescribes principles and actions that are fair to all those involved in health care (Beauchamp and Childress, 2001). The medical decisions made should be consistent with professional ethics and code of conduct unless in circumstances that can be justified to be “violated.” In the case of life-saving care for a minor child, this principle requires that the minor should get the appropriate treatment and the person deciding what treatments are administered should be competent. In addition, this principle implies that a parent has a duty to the child minor with serious need and that the physicians have a higher call of duty for such a minor because of their training and competence (Gaudine et al, 2011). Besides, it implies that the duty and responsibility of these persons are not diminished because of the nature of illness of the minor child. Therefore, they ought to make an appropriate decision that is fair and just. Since, parent’s responsibility is significant and cannot be ignored entirely, it is important that refusal of life-saving care for a minor child be put into perspective by all those involved to ensure that the minor child is treated accordingly (Clark, Cott, and Drinka, 2007). Conclusion It is clear that the four major ethical principles of autonomy, beneficence, non-maleficence, and justice are central to addressing the current healthcare issues. As it can be seen, they are the foundation of ethical analyses of any healthcare issue. More importantly, it can be seen that they are geared towards promoting benefits to the patient and reducing the possibility of harming the patient. In the case of parental refusal of life-saving care for a minor child, these ethical principles prove to provide sufficient ethical analysis considering that this health care issue is one of the most pertinent. References Beauchamp, T. & Childress, F. (2001). Principles of biomedical ethics. Oxford: Oxford University Press. Clark, P. G., Cott, C., & Drinka, T. K. (2007). Theory and practice in interprofessional ethics: A framework for understanding ethical issues in health care teams. Journal of Interprofessional Care, 21(6), 591-603. Gaudine, A. et al. (2011). Ethical conflicts with hospitals: The perspective of nurses and physicians. Nursing Ethics, 18(6), 756-766. Read More