Ethical Issues Raised When Parents Refuse Medical Treatment For their Ill Children

Submitted by Olga Zuyeva, BSN, MSHK, RNIII

Tags: child children ethical principles ethical principles in nursing ethical standards ethical values ethics nursing ethics parents treatment treatment options

Ethical Issues Raised When Parents Refuse Medical Treatment For their Ill Children

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Working as a nurse, I am seeing ethical issues raises when parents refuse medical treatment for their ill children. Health care providers need rapid access to legal remedies in order to help children whose parents neglect medical treatment for their young because of their religious beliefs and hopes that a miracle might heal the kids.  Despite those parents, who strongly stand by their point of view about spiritual treatment, doctors and state continue considering such point of view as futile, neglect, and abuse of the children. According to the doctors and courts, the medical treatment in ill children is more effective to cure disease in comparison to the spiritual means. As a society, we should make it a priority to protect children from parental neglect and abuse in case of withholding medical treatment, which in many cases leads to death.

The facts show that there is a need for an alternative way for medical professionals to get permission from the state to stop parents from refusing medical treatment for their children.  However, many parents still believe that the proposed medical treatments for their children are either highly invasive, painful, involving side effects, or may cause death. That is why some parents make a decision to withhold their children from being medically treated. Instead, they search for a prayer or a miracle to do a job of healing.

At times, a parental decision of withdrawal of a child from a certain medical treatment may put a minor at risk of getting health complications or even death. Health care professionals should make it a priority to educate parents in this area, therefore enhance their ability in making a right decision for their children. It is important to promote the knowledge of the available treatment options that can help sick children. 

Parents refused to provide medical care for their children based on their religious beliefs.  Minors were found to be neglected, when the parents declined the possibility of medical treatment that caused their children's lives.  The parents should be convicted in neglect and failure of providing medical care, despite of religious reasons.  With that being said, it becomes obvious that it is parent's responsibility to make a right decision on behalf of the minors and accept the available medical treatment options in order to treat the decease and avoid health complications or even death in young children.  Additionally, parents who believe in spiritual healing, need to view the use of religion oriented remedies as an alternative treatment, and never as a primary one.

Every human has a right to life, and that right should be protected by law.  It is each doctor's obligation to preserve a child's life where they can.  There are many ethical and legal issues about medical treatment and limitation of treatment for children with severe and fatal medical problems.  When issues arise with health care team or hospital management, the parents perceive some responses as legalistic and intimidating rather than constructive and compassionate. Over the last few decades, the law has been pleaded regularly by physicians and other health care providers concerned about the ethical and legal decisions.

After all, the parents may lose trust of the advice from doctors, which is central to the decision making process.  The quality of child’s life refers to emotional, social, and physical wellbeing and their intellectual capacity and also, ability to perform the ordinary tasks of living within community.  It can be difficult to predict whether a child will recover from any health problem, or develop disabilities. The families and health professionals have to make complex and emotionally demanding decisions about a child’s treatment and care.  When the parents are making decision about a child’s care there is no answer that is clearly “right “or “wrong”.  The communication between health care providers and parents should concentrate on how a decision should be made and who should make the decision. The health care providers should provide recommendations and conclusions in more detailed for the families to lower their frustration.  From ethical perspective, quality of life is hard to define.  Some parents have different opinions on what constitutes a “good” quality of life. 

One of the factors that influence the withdrawal of a child from medical treatment is religion.  When a child is seriously ill or injured, religious parents understandably will do everything to save him/her as long as it does not violate scripture.  Some parents believe that a child will make a miraculous recovery even when the doctors are certain that the situation is hopeless.  In many cases religion does provide needed comfort for many families of critically ill children. Many religious parents, however, do not stay away from using modern medicine, they rather use their faith as a supportive spiritual element in the process of healing of a child.  Ethical issues arise when parents choose to treat injury or a disease solely by a prayer, refusing medical care on behalf of their children, and putting them at risk of death.

According to facts, parents with certain religious backgrounds expect medical practitioners to accept and respect their cultural believes, and therefore understand their decisions and choices made in concerns of health care of their children. In the situations when doctors do not share the point of view of solely “faith healing”, the parents blame them for being insensitive toward their religious believes. The parents start seeing medical providers as individuals, who are not willing to listen or accept what is important to them. On another hand, doctors believe, when making recommendation on a child health care, that it’s parents’ responsibility to accept the treatment for healing their child’s illness, rather than rely only on a miracle. With that being said, doctors are certain that a prayer as a hope for a miracle could be used only as an alternative remedy for an ill child.

To resolve the problem of religious healing vs. using medicine in treating sick children, societal and religion-oriented remedies must be seen only as an alternative treatment.   In the First Amendment protection for the free exercise of religion and against a state establishment of religion, the competent parents have power to refuse medical treatment for themselves. The situation becomes more complicated when parents act on behalf of their minor children. A failure to provide medical care for a child can be seen as neglect, and become a basis for suspending or terminating of the parental rights. However, when parents refuse medical treatment for their young, or choose unconventional forms of treatment like spiritual healing or religious believes, this choice is often falls under statutory protection. The First Amendment provides that “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof.”  The parental autonomy over minor children is not an absolute right however. The health and safety of a minor child must become public if found in jeopardy of not being properly addressed by a parent. The obligation of health care professionals is to do what is in the best interests of a child.

In conclusion, it is very important to stress one more time that everyone's right to life is protected by law. Also, it is needless to say, that it has been proven over and over again that a prayer alone is just not enough to heal. For that matter, health care providers must find a faster legal path to reach out and prevent death in children whose parents refuse medical treatment due to their religious beliefs and hopes for a miracle for their sick children. In a meanwhile the children still remain not being medically treated and fall in danger of manslaughter indictment and parental neglect.  It is important to see the parent-child relationship as the one where an adult explores all the options to ensure the safety and health of a minor child. Otherwise, failure to provide a minor child with proper needed medical treatment will result in termination of parental rights as a condition governed by statue or the common law.

Works Cited:

  1. Amendments to the Constitution of the United States of America.             
  2. Bankhead, C. (2012). End – of – Life Care for Kids Raises Ethics Issues. MedPage Today.
  3. Critical Care Decisions in Fetal and Neonatal Medicine: Ethical Issue. (2006). Published by Nuffield Council on Bioethics.             
  4. Furrow, B. R., Greaney, T. L., Johnson, S. H., Jost, T. S., Schwartz, R. L. (2013). Bioethics: Health Care Law and Ethics. 7 th ed.
  5. Florida Statutes, section 827.04 (1), 2011 Florida Statutes, section 415.503.    Protection from Abuse, Neglect, and Exploitation.
  6. Hall, D. E. (2015). Administrative Law: Bureaucracy in a Democracy. 6th edition. Pearson/ Prentice Hall.
  7. Hill, S. (2012). The Awful Consequences of Misplaced Hope for a Miracle Cure. Doubtful News.
  8. Ingram, J.D. (1988). State Interference with Religiously Motivated Decisions on Medical Treatment. 93 Dick. L. Rev.41. Westlaw Next.
  9. Macer, D. (2004). Making Choices, Diversity and Bioethics. Bioethics Education for Informed Citizens across Cultures. Ch. 1.         
  10. Neporent, L. (2012). Deeply Religious Parents Often Reluctant to Cease Medical Care. ABC News.