The child who refuses to undergo anesthesia and surgery--a case scenario-based discussion of the ethical and legal issues.
Situations where children refuse to undergo anesthesia and surgery can be challenging for anesthetists. Clear legal guidelines are lacking and decisions often need to be made with a degree of urgency. When a child refuses to cooperate with the induction of anesthesia, it is important to consider the autonomous capacity of the child, the presence of a legally valid consent from a suitable guardian, the urgency with which the surgery needs to proceed and the practical implications of proceeding without the child's cooperation. In this article, case scenarios are used to demonstrate how these considerations can be applied in practice.
Department of Anaesthesia, Middlemore Hospital, Auckland 1640, New Zealand. heidiwalker@xtra.co.nz
Heidi
H
Walker
D000758:Anesthesia / Q000941:ethics* / Q000523:psychology; D000769:Anesthesia, Inhalation / Q000941:ethics / Q000523:psychology; D001007:Anxiety / Q000523:psychology; D001065:Appendix / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003657:Decision Making; D004431:Ear, External / Q000601:surgery; D005239:Fear / Q000523:psychology; D005260:Female; D006801:Humans; D007258:Informed Consent; D007813:Laparotomy; D008297:Male; D009520:New Zealand; D011292:Premedication; D013514:Surgical Procedures, Operative / Q000941:ethics* / Q000331:legislation & jurisprudence* / Q000523:psychology; D014068:Tonsillectomy / Q000941:ethics; D016312:Treatment Refusal / Q000941:ethics* / Q000331:legislation & jurisprudence* / Q000523:psychology