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?
Rather than turning away children whose parents refuse to have them vaccinated, pediatricians should engage the parents in discussion about the importance and safety of vaccination.
Jalayne J. Arias, JD, MA and Kathryn L. Weise, MD, MA
Even when external factors such as nonaccidental injury weigh heavily on clinicians' perceptions, they should not lose focus on the patient's best interest when deciding whether to continue or withdraw treatment.
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.
Karen Uhlenhuth, Angira Patel, MD, and John Lantos, MD
A statin drug will not give a 10-year-old a high level of energy, the freedom to interact with peers without fear of being bullied, or a generally happy outlook on life.