Clinical case and commentary on how physicians should respond when confronted by medication requests from parents of children with mood and concentration disorders.
Anne-Marie Laberge, MD, MPH and Wylie Burke, MD, PhD
Two physicians examine the risks of testing minor children for late-onset genetic diseases when there is no current benefit and explain why several medical associations oppose the practice.
Physicians should understand and be sensitive to all of the issues that affect patients when they prescribe the tertogenic medication isotretinoin for treatment of acne vulgaris.
A bioethicist argues that children with Down syndrome should not be subjected to cosmetic surgery to change their appearance unless they are at the age and have the capacity to make the decision for themselves.
Physicians should be aware of the level of emotional distress and suffering that a patient is experiencing as a result of his or her illness and incorporate that into the patient's treatment plan.
Physicians should demonstrate compassion when the parent of an ill child asks the physician for his or her personal opinion regarding the parents' choice to continue experimental treatment when the prognosis is not good.
Physicians who treat children with Down's syndrome should ensure that their parents fully understand the children's capabilities and long-term prognosis and counsel them on the appropriate actions to take regarding their children's care.
Physicians need to manage expectations and clearly explain the prognosis of ICU patients to their families, particularly when the outcome is a negative one.
Parents' ability to make medical decisions for their children can be limited by state law if it is determined that the child's best interest is not being met.