When a seriously ill mature minor and his parent disagree about his receiving an experimental intervention, who should decide what treatment he will receive?
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.
Patricia D. Quigley, MD and Megan A. Moreno, MD, MSEd, MPH
Maintaining an adolescent’s confidentiality while answering his or her parents’ questions about their child’s change in mood and behavior can be challenging.
Loss of personal integrity, the emotional and psychological costs of “pronoun switching,” and actively managing one’s presentation can be time-consuming and exhausting.