Question

1. What is the ethical dilemma of Child refusing treatment (e.g. wants to stop chemotherapy for cancer)
2. Identify the key elements (who, what, when, how, why) of a child refusing treatment?
3. Identify the resources at the clinical agency or in the community to assist in dealing with the child refusing treatment. Identify resources available for your chosen dilemma. Identify resources available through your clinical facility and in the community (including organizations for your specific topic).

Answer 1

ETHICAL DILEMMA IN CHILD REFUSING TREATMENT

A competent child is legally entitled to withhold consent to treatment. However, even though the child or young person may be considered to be Gillick competent, there are some situations where their refusal can be overridden by those with parental responsibility.

WHEN CAN CHILD GIVE CONSENT-The child can give consent in following stages

1. Medical Treatment - If they are more than 12years of age and understands the benefits ,risk , social and other implication of the treatment.

2. Surgical procedure - If they are more than 12years of age and duly assisted by their parents or guardian.

3. If children lacked capacity to do so a parent or legal guardian may give a consent to refuse the medical treatment.

Competent minor successfully refuse treatment in the chemotherapy of cancer and even parents can refuse treatment.

REASONS-

1. They prefer complementary and alternative medicine.

2. They have faith based reasons

3. They are concerned about adverse effects.

4. They lack insight into the patients treatment needs.

HOW

The minor or child can refuse treatment by using "Mature minor " doctrine which recognizes that some minor are mature enough to evaluate the treatment options and to make their own decision.

REASONS TO ASSIST CHILD REFUSING TREATMENT

1. When a child is refusing chemotherapy who has been diagnosed with cancer then the doctor should first know the reason for refusal and should make them comfortable and get more and more involved in childcare.

2. COMMUNITY REINFORCEMENT AND FAMILY TRAINING (CRAFT ) is an approach family members and can use motivate behavior change in a loved one who is ignoring the treatment.

3. Another resource can be to focus on another problem that a child is experiencing like anxiety ,etc. which can be discussed and motivate them for treatment.

4. The doctors can show them infrastructure facilities available, assure them that treatment is done by most trusted doctors.