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.
Patients who use drugs intravenously may be at high risk for relapse, but their situation is no more futile than that of persons with diabetes and coronary artery disease who smoke and frequent all-you-can-eat buffets.