Christian Scientist scenario

[Rialaigh]

Do you have any sources to cite? Evidence presented in this thread so far seems to discredit your statement.

Thirty-eight states and the District of Columbia have religious exemptions in their civil codes on child abuse or neglect including decisions about healthcare.
Seventeen states have religious defenses to felony crimes against children including results from decisions about healthcare.

Hospitals and ethics boards frequently label people "mature minors" and allow them to refuse medical care on the grounds of religion. Some as young as 12-14 can refuse life saving treatment for themselves.

Take a look here and read through some cases and some of the legislation that is currently active

http://childrenshealthcare.org/

 

[Nameless]

I didn't think this would get as much input as it's getting! Awesome! I'm loving reading all of these answers. To those that mentioned ethics being important in the field, I wholeheartedly agree.

If it were me in the situation, I'd perform care. If the father didn't have a weapon of any sort (gun, blunt weapon, knife, etc.). I'd load the kid up, meet ALS en route (or if we're an ALS unit, the medic would probably agree with me and be working him), nearest specialty center, and then take the fallout of essentially abducting the kid later on. Gather all of my objective statements and fill out the necessary paperwork. I don't think I could have it on my conscious that I walked away from something of this sort.

I respect the parents' right to believe what they what, but I don't respect their decision to hinder their child's life based on their beliefs. That's just me, though. Gotta love philosophy.

 

[bbmtnbb]

you request le emergent.

An unresponsive, possible pediatric arrest will free up cops faster than you can blink your eyes.

.

this ^^^^^^

 

[medicsb]

[Deleted for expressing attitude to wrong poster. Sorry, y'all.]

 

[wanderingmedic]

Redacted for above reason.

 

[STXmedic]

So these parent's beliefs prevent medical care for their child. They are obviously fairly convicted if they're willing to take the chance of their child dying. Weapon or not, do you seriously think they're going to let you walk up, take their kid from them, and drive away without intervening? (Hint: not likely).

I understand the want to treat the child. I don't think it would be an easy thing to do, and would probably take a mental toll on me at some point. But who are we to force someone to violate their religious and spiritual beliefs.

 

[medicsb]

Yes...that comment was in response to Rialaigh's post which seemed to disagree with the stuff from the American Academy of Pediatrics.

HHhhmmm, yes, this was my folly. My apologies.

 

[bbmtnbb]

Found on an attorney's web site-lots of court cases cited and scenarios but can't find one in the field-suggest MD on phone ASAP and PD en route for possibly dead/dying kid parents refuse to let you treat and let the MD give orders whereby HE/SHE took the child into protective custody and you are his/her arm in treatment. I FOR ONE WOULD NOT WALK AWAY!

https://www.thesullivangroup.com/risk_resources/refusal/refusal_2_refusal.asp


The courts have held that denying medical care to a child is not within the parents' First Amendment right of freedom of religion: "The right to practice religion freely does not include the liberty to expose... a child... to ill health or death. Parents may be free to become martyrs themselves. But it does not follow that they are free ... to make martyrs of their children..." State v. Perricone, N.J.Rep., Vol. 37, p. 463, Atlantic Reporter, 2d Series, Vol 181, p. 751, 1962.

Generally, state and federal courts support parental control over the basic matters affecting their children. However, when parental actions have resulted in inadequate medical care, courts in the United States have stepped in to decide between parent wishes and physician concerns. Under the doctrine of "parens patriae" (the state's paternalistic interest in children) the state will not allow a child's health to be seriously jeopardized because of the parent's limitations or convictions. A parent does not have the authority to forbid saving their child's life. Courts invariably rule in favor of a physician who claims that a parent is denying standard medical care to a child.

Under the doctrine of parens patriae, the state represents the best interests of the child. The state also looks to the child abuse and neglect statutes, which provide for protective custody when the child has not received medically indicated treatment.

Once again, the emergency physician is empowered by understanding the law. If parents withhold consent, and there is a life threat, the emergency physician should take temporary protective custody based on child neglect. It helps to explain to the parents that this is a medical obligation under the law, and you will immediately report to the hospital administrator, hospital attorney and the local child protection agency. The parents will typically stand down and allow you to proceed with your mission. Even in situations where the minor's life may not be threatened but severely impaired, the courts usually will order medical treatment over the parents objections.


His Surmation:
1. Review of pediatric refusal of care issues:

a. In emergency situations, defined as conditions requiring prompt treatment, and not limited to potentially fatal or disabling conditions, any child may be treated without parental consent.

b. Failure to provide treatment in these circumstances may constitute negligence.

c. If treatment may entail risk, it is prudent to obtain a second opinion regarding the need for prompt treatment. Second opinions and attempts to contact the parents should be documented in the chart.

d. "Emancipated" or minors living on their own who are self-supporting and not subject to parental control, a definition that includes college students and unmarried minor mothers, may provide their own consent for treatment.

e. Statutes enacted by many states allow minors to give permission for treatment of venereal disease, or drug or alcohol problems without parental consent, and prohibit informing the parent regarding such treatment (including sending a bill) without the consent of the minor.

f. The "mature minor" rule based on multiple court decisions, indicates that young people who are capable of providing appropriate informed consent may give valid consent for treatment which does not involve serious risks. Although minors have a corresponding right to refuse treatment, it appears to be doubtful the courts will uphold the rights of a minor to refuse treatment that may be life saving.

g. It is noted that, in the past 30 years, no cases have been reported in which a parent has successfully sued a physician for the non-negligent care of an adolescent provided without parental consent.

 

[VFlutter]

Nevermind.

 

[TheLocalMedic]

So these parent's beliefs prevent medical care for their child. They are obviously fairly convicted if they're willing to take the chance of their child dying. Weapon or not, do you seriously think they're going to let you walk up, take their kid from them, and drive away without intervening? (Hint: not likely).

I understand the want to treat the child. I don't think it would be an easy thing to do, and would probably take a mental toll on me at some point. But who are we to force someone to violate their religious and spiritual beliefs.

"Who are we to force someone to violate their religious and spiritual beliefs"??? I'm a paramedic, that's who. Religious beliefs are all well and good, but ethically and legally I will not allow a parent to let their own child die.

Again, the only thing stopping me from physically ripping that kid out of the parents' arms would be if they were willing and able to take me out. And I'm a big guy, so I can hold my own in a fight.

If I cannot reason with them (your child may die without immediate help) then they get pushed out of the way and that kid comes with me. I'm more than happy to pick up an assault charge if it means getting that kid life saving care. And I'd like to see any jury in the world convict me in that scenario.

Maybe I'm hot headed, but this thread really struck something in me. And I believe that anyone who says they'd walk away is full of it. Walking away is not only ignorant, misguided and unethical, but will also find you on the pointy end of a prosecutor's interrogation for negligence.

 

[STXmedic]

"Who are we to force someone to violate their religious and spiritual beliefs"??? I'm a paramedic, that's who. Religious beliefs are all well and good, but ethically and legally I will not allow a parent to let their own child die.

Again, the only thing stopping me from physically ripping that kid out of the parents' arms would be if they were willing and able to take me out. And I'm a big guy, so I can hold my own in a fight.

If I cannot reason with them (your child may die without immediate help) then they get pushed out of the way and that kid comes with me. I'm more than happy to pick up an assault charge if it means getting that kid life saving care. And I'd like to see any jury in the world convict me in that scenario.

Maybe I'm hot headed, but this thread really struck something in me. And I believe that anyone who says they'd walk away is full of it. Walking away is not only ignorant, misguided and unethical, but will also find you on the pointy end of a prosecutor's interrogation for negligence.

There are some very well-reasoned and well-argued posts on here that have already made me reconsider my position. I had a poor understanding of the extent of religious protection. I still have no intention of physically fighting parents off of their child, but I would certainly be more proactive than I'd have originally considered.

This is not one, nor are any of your previous posts in this thread. The only thing that stands out is the bolded, evidenced by the italicized (just one example).

The point is not to call you out, though. The point is that there is a good way to change beliefs, and a way that just demeans and pisses people off.*



*Any APs, please disregard the current irony...

 

[TheLocalMedic]

The point is not to call you out, though. The point is that there is a good way to change beliefs, and a way that just demeans and pisses people off.

Granted, I may sound demeaning, and I may piss people off, but some of the reactions from people in this post made my blood absolutely boil. It makes me question whether those people who say they'd just walk away have ever actually worked in the field and had to deal with tough ethical dilemmas. Maybe they have, but the sense I got was that they were only conscious of a very classroom-based view of ethics.

 

[Handsome Robb]

I'm gonna ask a question.

How many people here have actually worked a pediatric arrest? I have. Multiple times.

You can talk about what you'd do until you're blue in the face. When you really have to make decisions is when there's a dead kid in front of you.

I'm not fighting the parents. I'm not catching a charge. I will do everything in my power for that child but it's not my kid, I'm not sacrificing my livelihood by collecting a violent charge while on duty and potentially jeopardizing my livelihood.

Just another angle to consider.

What would your wife and kids day if you came home and told them you lost your job?

 

[STXmedic]

I've worked a few. Normally the child is being thrown at you, though, not pulled away. This scenario is one that most people will never see in their entire career. I do not envy the unfortunate medic faced with such a dilemma. If it were me, the only thing I'm sure of is that I'll be going home at the end of the day, and I will do nothing to jeopardize that.

 

[TheLocalMedic]

I've had several pediatric arrests, and never had I had anyone try and stop me from accessing the child. But if there's a dying child in front of me with a parent between us saying that their religious beliefs won't allow me to help them, then I'm willing to do what it takes to get that child the care they need. I can't imagine a parent wanting to stop me, but if they did, I would have an immediate problem with them. And if they can't be reasoned with, then they're getting out of the way, one way or another.

I don't consider it "jeopardizing my job" in that scenario. I call it doing whatever it takes to try and save a child.

If it's a kid with a skinned knee, that's a different story. But this scenario calls for a collapse where the kid doesn't appear to be breathing. You can call the cops, but that kid will be dead by the time they get there. So unless there's significant risk to my life, I'm going in.

Honestly, I'd rather risk an accusation of assault than stand by and watch a child die. I'm sure that this particular predicament will never actually present itself, but that's where I stand on the issue.

 

[Handsome Robb]

That's what I was getting at. In a little over a year I've had 4 working and one obvious. 3 months, 18 months, 22 months, 24 months and 16 years. Obvious was a 8 month old.

I have no doubt something like this has happened but I've never had a family try to interfere. Like Local and STX said the child is generally thrown at your as soon as you get out of the ambulance.

Telling the obvious one's parents was the most difficult thing I've had to do in my career. Hands down.

I have no doubt you'd run into resistance originally in a situation like this but even then once mommy and daddy realize little jimmy isn't coming back without help they'll change their minds. I've always wondered why communications isn't a prerequisite for EMS and/or included in the class...

Not a child but I had a 19 year old very devout Muslim woman with a severe neck injury. Had an extensive history of injuries and congenital problems. Present with severe generalize neuro deficits after yoga and feeling a pop in her high T low C spine. Other than requesting we remove our boots and meeting in the middle with disposable pillow cases as shoe covered they allowed us to treat her as we saw for provided we communicated what we wanted to do before we do it.

Point of the story is communication skills can go a long way.

 

[MonkeyArrow]

I've had several pediatric arrests, and never had I had anyone try and stop me from accessing the child. But if there's a dying child in front of me with a parent between us saying that their religious beliefs won't allow me to help them, then I'm willing to do what it takes to get that child the care they need. I can't imagine a parent wanting to stop me, but if they did, I would have an immediate problem with them. And if they can't be reasoned with, then they're getting out of the way, one way or another.

I don't consider it "jeopardizing my job" in that scenario. I call it doing whatever it takes to try and save a child.

If it's a kid with a skinned knee, that's a different story. But this scenario calls for a collapse where the kid doesn't appear to be breathing. You can call the cops, but that kid will be dead by the time they get there. So unless there's significant risk to my life, I'm going in.

Honestly, I'd rather risk an accusation of assault than stand by and watch a child die. I'm sure that this particular predicament will never actually present itself, but that's where I stand on the issue.

The point that I have a problem with your actions is the point where you intervene against the parents wishes, in a not so nice way, and you still lose the child. Now where does that get you? You have obviously violated the parent's religious beliefs by pumping their child full of meds and doing all these ALS interventions and the child is still dead. I would say that you have doubled the hurt almost; you took away their child and their religion away in one action (of course assuming that for someone to prevent treatment of their dying child because of religion, they are truly devoted to said religion). We all know the statistics of arrest survivals, especially in peds where the cause is more likely going to be a congenital defect that may or may not go into VF/VT/Torsades. Now, you have a kid who is dead (who you might have never been ever to save), a severe religious issue with the parents, and legal issues (which the jury will not like since the kid is dead as opposed to being alive). I almost think that this situation is like the coach who decides to go for the game winning 2 pointer instead of the tying extra point. If the two point converts, he's a hero and everyone's good. But if they miss the two pointer, what a horrible call.

EDIT: Neither have I faced a situation like this nor do I hope I ever have to.

 

[Av8or007]

When ones religious beliefs prevent a child from ever being able to have their own beliefs or life then saving the child takes precedence.

Primium non nocere.

 

[TheLocalMedic]

We all know the statistics of arrest survivals, especially in peds where the cause is more likely going to be a congenital defect that may or may not go into VF/VT/Torsades. Now, you have a kid who is dead (who you might have never been ever to save), a severe religious issue with the parents, and legal issues (which the jury will not like since the kid is dead as opposed to being alive). I almost think that this situation is like the coach who decides to go for the game winning 2 pointer instead of the tying extra point. If the two point converts, he's a hero and everyone's good. But if they miss the two pointer, what a horrible call.

Just because the odds aren't in my favor doesn't mean that I'm not going to give it my all. ESPECIALLY because it's a kid. And if that means the parents' feelings get hurt, then so be it. And as to the football reference, in this case there isn't an option to go for a field goal. There is no second best in this situation.

 

[Anonymous]

Pretty much agree with everything TheLocalMedic has said.

EMS is filled with ethical and legal questions like this. They used to drive me nuts, darned if you do, and darned if you don't. At the end of the day I am going to do what I believe to be right in my heart. No different than if I was not on duty. If I have to come home and tell my wife and kid I lost my job for trying to save a child then so be it, and I know they would;t think any less of me because of it. I am shocked that this issue is so divided. There goes the reasonable "prudent" man protection I used to find comfort in. I sure hope that the day a medic finds himself in a court room defending himself for something like this there is not one of you sitting across on the prosecution side saying "oh no I would have walked away and respected the parent's wishes."