Situations in which the patient’s family seems not to be acting in good faith or the patient's suffering is uncontrollable are relatively rare and do not warrant giving physicians unilateral power to withhold or withdraw treatment in all cases of perceived medical futility.
When a seriously ill mature minor and his parent disagree about his receiving an experimental intervention, who should decide what treatment he will receive?
When a severely ill child comes into the emergency room, assent for emergency care is no more required than is parental permission. Conveying the needed care is the top priority.
Forcing parents to participate in treatment is unlikely to succeed. Seeking to optimize the therapeutic alliance between family and pediatrician is more likely to achieve the desired outcome—the child’s short- and long-term well-being.