Review these questions regarding pediatric care
Ethics committees can alleviate conflicts
The Los Angeles County Bar and Medical Associations’ joint committee on biomedical ethics recently finalized guidelines for foregoing life-sustaining treatment of minors. Although the guidelines aren’t legally binding, they serve as a tool for health care providers and the courts when decisions about the care of terminally or seriously ill child must be made. The committee’s previously published guidelines for adult care have been cited by nine courts in California and elsewhere.
Robyn Meinhardt, RN, JD, current co-chair of the joint committee, recommends that health care ethics committees concerned with life-sustaining treatment decisions regarding pediatric patients ask the following four questions.
What can your institution offer?
1. What mechanisms does your institution have to assist minor patients and their families understand and make decisions about life- sustaining treatment? Are culturally and socially sensitive and bilingual patient advocates available? Is the minor patient appropriately involved and represented in the decision-making process?
2. Is there an official or unofficial forum for members of a minor patient’s health care team to meet to determine the best course of action for that patient, ensure consistent communication with the minor patient and the family, and resolve differences of opinion among the team with regard to the minor’s treatment?
3. Are physicians, other health care professionals, and parents aware of the institution’s resources, such as a bioethics committee, that can help them determine the best course of action for a minor patient? From the risk management perspective, are all available resources used to help parents feel more involved in the decisions related to medical treatment for their child and thus more satisfied with the health care experience?
4. Do physicians and other health care professionals have copies of and understand the requirements concerning reports to local child protective services? Does the hospital seek the help of its legal counsel and/or state attorney general’s office to interpret difficult situations?
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