title: When a foreign adolescent orphan refuses to be treated: Considerations on a clinical case.
abstract: Providing medical treatment for unaccompanied foreign minors can prove particularly demanding when a patient is not fully compliant. This report describes the case of a 13-year-old boy from Sub-Saharan Africa brought to Italy to receive treatment for a neoplasm. Right from the start, he showed strong oppositional reactions, with aggressive and self-harming behavior. This made it necessary to activate various different psychological, psychiatric, and social-support resources, and to adapt the proposed treatments to the patient's willingness and ability to cooperate. Here we outline the assessments and actions (also from the economic and organizational standpoint) that need to be implemented in any scheme to bring young foreign orphans to Italy for specialist medical care.
authors: Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti,Università degli Studi di Milano,Italy.
authors: Carlo Alfredo
authors: CA
authors: Clerici
authors: SC Pediatria,Fondazione IRCCS,Istituto Nazionale dei Tumori,Milano,Italy.
authors: Giovanna
authors: G
authors: Casiraghi
authors: SC Pediatria,Fondazione IRCCS,Istituto Nazionale dei Tumori,Milano,Italy.
authors: Laura
authors: L
authors: Veneroni
authors: SC Radioterapia Oncologica 1,SS Radioterapia Pediatrica,Fondazione IRCCS,Istituto Nazionale dei Tumori,Milano,Italy.
authors: Emilia
authors: E
authors: Pecori
authors: Cappellania Ospedaliera,Fondazione IRCCS,Istituto Nazionale dei Tumori,Milano,Italy.
authors: Tullio
authors: T
authors: Proserpio
authors: SC Radioterapia Oncologica 1,SS Radioterapia Pediatrica,Fondazione IRCCS,Istituto Nazionale dei Tumori,Milano,Italy.
authors: Lorenza
authors: L
authors: Gandola
authors: SC Pediatria,Fondazione IRCCS,Istituto Nazionale dei Tumori,Milano,Italy.
authors: Maura
authors: M
authors: Massimino
mesh_terms: D000293:Adolescent; D054540:Child, Orphaned / Q000523:psychology*; D054242:Emigrants and Immigrants / Q000523:psychology; D006801:Humans; D007398:Interpersonal Relations; D007558:Italy; D008232:Lymphoproliferative Disorders / Q000523:psychology / Q000628:therapy*; D008297:Male; D012944:Social Support; D013636:Tanzania; D016312:Treatment Refusal / Q000523:psychology*
keywords: Adolescents; Noncompliance; Oncology; Self-harm