Hi. I am Art Caplan, and I am at the division of medical
ethics at the New York University (NYU) School of Medicine…
What is the ability of the state to override parental
authority, and what is your obligation to do something if you think parents are
pursuing a course of action that is not in their child's best interest? Well,
people can intervene under the following circumstances: If there is a
life-threatening condition, you certainly can report a family that is not
taking action on that life-threatening condition to social services at the city
or state level, and you should.
Courts will override parents if they think there is an
efficacious intervention, such as insulin for diabetes or antibiotics for
meningitis, where the child can benefit. It is harder to get experimental novel
treatments ordered by courts; they will give more discretion to parents in
those situations.
It is also the case that if the parents are basically trying
to pray, sometimes medicine can work with them. You pray, we will do the
medical treatments; maybe they will accept working together. I have seen that
happen in some instances.
You have an obligation if you learn or hear from a midwife
or anybody who has been involved in childcare—a babysitter, whoever—that a
child is sick, and they are concerned, that should be reported to child
welfare. Again, the county, the city, or the state—any of those will do. You
could report it to the police. Once reported, you are out of the game. You do
not have to worry too much because they will take it up and try to investigate
and make sure that the child is being protected.
I know very well that many of these services are busy and
overwhelmed, but they make time, and they do try to look out, particularly for
children who might not be getting the necessary medical care that they need.
You cannot prevent every instance of parents not showing up
within the medical systems. Sometimes they are just outside of the safety net.
Sometimes they can stay off the grid, and you do not find out, tragically,
until it is too late.
I favor prosecuting those cases because it sends a message
that it will not be tolerated, even though I do not think that these parents
need to go to jail. I think that they need to be sentenced to community
volunteerism. There is no point in punishing them; they have lost their child,
they are grieving, but having prosecutions occur does send the message that the
community will not put up with prayer as an alternative to established medical
care.
At the end of the day, child welfare and the child's best
interest can override parental discretion and parental choice, and in some
instances, it has to.
Issues to consider:
Failure to provide children with essential medical care has
been increasingly recognized as a form of neglect. In 1983, the US Department
of Health and Human Services amended its definition of negligent treatment to
include failure to provide adequate medical care.
Many healthcare professionals are concerned that although
parents have broad authority, they have less discretion in making medical
decisions for their children than for themselves.
Some healthcare professionals contend that although the free
exercise of religion, including parents teaching their children their religious
beliefs, is an important societal value, it must be balanced against other
important societal values such as protecting children from serious harm.
The courts have consistently ordered life-saving medical
treatment over parental religious objections. In passages frequently quoted in
subsequent rulings, the US Supreme Court famously stated, "The right to
practice religion freely does not include liberty to expose the community or
the child to communicable disease or the latter to ill health or death,"
and "Parents may be free to become martyrs themselves. But it does not
follow they are free, in identical circumstances, to make martyrs of their
children before they have reached the age of full and legal discretion when
they can make that choice for themselves."
Several US studies found that adults from different
racial/ethnic and socioeconomic groups generally agree on what constitutes
child neglect.
Although society generally believes that parents or
guardians are best situated to understand their child's unique needs, including
healthcare needs, and should participate in caring and thoughtful medical
decision-making, this parental responsibility is not an absolute right. For
instance, some healthcare professionals believe that it is critical to design
childhood immunization exemption policies so that they clearly serve the best
interests of both the individual child and the community.
https://www.medscape.com/viewarticle/887406
No comments:
Post a Comment