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ETHICS IN MEDICINE   University of Washington School of Medicine

Cross-cultural Issues and Diverse Beliefs

Case 3 Discussion

The physician has a duty to challenge the decision of parents when their refusal of treatment would pose a significant risk of substantial harm. Failure to diagnose and treat bacterial meningitis would seriously threaten the health and even life of this child. The physician should share his or her view with the family and seek to elicit their cooperation through respectful discussion. The physicians should be open to alternatives that satisfy the parents’ concerns and achieve the goal of keeping the child safe. Inviting the family’s religious leader to the hospital while also providing standard medical therapy may prove to be an acceptable compromise. Should these efforts not result in parental permission, the physician is justified in seeking legal authority (in the form of a court order of authorization from a state child protection agency) to proceed with the procedure and treatment of the child. In most states a physician is legally authorized to provide emergency treatment to a child without a court order when delay would likely result in harm.

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