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Old 05-16-2012
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Medicolegal and Ethics Ethics-Life saving treatment

When we say that parents cannot refuse life/limb saving treatment for their children, what do we mean? What exactly is life saving treatment? Is it the intent or the outcome which matters?

For ex, a 10 yr old boy with ALL is admitted under your care with a respiratory infection and severe anemia. He was diagnosed 3 years back and relapsed twice since then, having received chemotherapy. You suggest a bone marrow transplant. His parents tell you they do not wish to see their child suffer any further and deny consent for transplant and ask you to "make him comfortable".
What will you do?
In this case, a transplant would provide maybe 2-4 years of life to the child. Survival rate and event free survival is pretty bad for relapsed ALL patients. However there are patients(although very few) who have achieved long term remission this way.
Is the intent which counts?(giving the child a few extra years of life, after some pretty nasty chemo and post transplant morbidity). OR Is it the outcome(the quality of life isn't what you or the parents want for their child)?
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Old 05-16-2012
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If there is still a small chance of complete recovery - you have the right not to listen to these wonderful parents and go on with life-saving procedure.
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Old 05-16-2012
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side effects are still better than death.

in life threatening situations, you do everything you can in order to help even by 1%.

now if treatment is futile and theres no way of treating them, theres no need to give a treatment that helps in no way.

but if you can help even a bit, regardless of side effects or parents' wishes, you have to do it.
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Old 05-16-2012
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If you want to proceed with transplant, I believe you'll have to get a court order.

That said in this case since the parents have refused treatment, and you know that it's very unlikely that the transplant will CURE the patient, you should listen to the parents. If the treatment can't cure the patient or improve their life in any significant way, then there's no point putting them through painful procedures.
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Old 05-16-2012
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Quote:
Originally Posted by slowpoke View Post
If you want to proceed with transplant, I believe you'll have to get a court order.

That said in this case since the parents have refused treatment, and you know that it's very unlikely that the transplant will CURE the patient, you should listen to the parents. If the treatment can't cure the patient or improve their life in any significant way, then there's no point putting them through painful procedures.
I agree. And I don't think a question like this would be asked in the exam.
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