title: Are Pediatricians Complicit in Vitamin K Deficiency Bleeding?
abstract: The American Academy of Pediatrics recommends that all newborns receive a single dose of intramuscular vitamin K to prevent vitamin K deficiency bleeding. How should the clinician respond when parents decline vitamin K? Although vitamin K deficiency bleeding can have devastating sequelae, they are uncommon; therefore, parents are generally allowed to decline vitamin K after counseling is provided. When parents ask for a vitamin K preparation of unproven effectiveness, should the clinician honor that request? To address these questions, we present a case of a healthy newborn whose parents declined intramuscular vitamin K and requested an oral preparation. Two general pediatricians discuss the medical and ethical issues these situations pose, and the parents describe their experience.
authors.affiliation: Department of Pediatrics, Oregon Health & Science University, Portland, Oregon; weddle@ohsu.edu.
authors.forename: Melissa
authors.initials: M
authors.lastname: Weddle
authors.affiliation: Department of Pediatrics, Oregon Health & Science University, Portland, Oregon;
authors.forename: Allison
authors.initials: A
authors.lastname: Empey
authors.affiliation: Department of Pediatrics, University of California, San Francisco, California; and.
authors.forename: Eric
authors.initials: E
authors.lastname: Crossen
authors.affiliation: Vancouver, Washington.
authors.forename: Aaron
authors.initials: A
authors.lastname: Green
authors.affiliation: Vancouver, Washington.
authors.forename: Joy
authors.initials: J
authors.lastname: Green
authors.affiliation: Department of Pediatrics, Oregon Health & Science University, Portland, Oregon;
authors.forename: Carrie A
authors.initials: CA
authors.lastname: Phillipi
mesh_terms: D005260:Female; D006801:Humans; D007231:Infant, Newborn; D010290:Parents; D010372:Pediatrics; D016312:Treatment Refusal / Q000941:ethics; D014812:Vitamin K / Q000627:therapeutic use*; D006475:Vitamin K Deficiency Bleeding / Q000517:prevention & control*; D014815:Vitamins / Q000627:therapeutic use*
chemical_list: D014815:Vitamins; D014812:Vitamin K