An ethics dilemma: when parents and doctors disagree on the best treatment for the child.
The increasing complexity of present day medicine--with highly effective and yet risky treatments, individual and collective expectations, and evolving ideological and cultural landmarks--often gives rise to difficult ethical problems. Specific meetings are valuable for understanding such problems, acquiring the relevant skills and for gaining and transmitting experience on how to solve them. Parents and doctors may disagree about what is the best treatment. Such a difference of opinion is not rare but usually a solution can easily be found. This is not the case when the child is treated for a severe illness and when there is no clearly defined or satisfactory treatment for him\her. We present how a dramatic conflict arose between the parents and the doctors faced with such a case (mostly because the staff failed to understand early enough the psychological factors at the root of the father's demands), how clinical, institutional and ethical problems were analysed during a meeting, and how they were solved.
Oppenheim
Daniel
D
Département de pédiatrie et unité de psycho-oncologie, Institut Gustave-Roussy, 94805 Villejuif. openheim@igr.fr
Brugières
Laurence
L
Corradini
Nadège
N
Vivant
Florence
F
Hartmann
Olivier
O
D001291:Attitude of Health Personnel; D001932:Brain Neoplasms / Q000523:psychology / Q000628:therapy*; D002675:Child, Preschool; D003131:Combined Modality Therapy / Q000379:methods; D034462:Dissent and Disputes; D004992:Ethics, Medical; D017809:Fatal Outcome; D005219:Father-Child Relations; D006167:Guilt; D006801:Humans; D008297:Male; D018447:Medical Futility; D008527:Medulloblastoma / Q000523:psychology / Q000628:therapy*; D017008:Negotiating; D010166:Palliative Care; D010290:Parents / Q000523:psychology; D010332:Paternal Behavior; D019555:Physician-Nurse Relations; D011379:Prognosis; D033581:Stem Cell Transplantation