When faith clashes with medical care

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There is a significant difference between a patient who refuses medical treatment that is available to him, and a woman who is refused medical treatment that she wants.

If we subscribe to the principle that the patient has the ultimate authority of what is done, or isn't done to the patient's body, then we cannot put these two situations into the same column.

That's a completely different set of circumstances, as visagrunt rightly says. I remember that this case was very sad for everyone all round.

An adult can choose to be stupid with their own life,it's their right.But I don't think they have the right to inflict needless suffering on the kids.If the child's life is in danger than they are unfit to be parents.Remove the kids,give them medical help.

But what if the kid doesn't want treatment? A child of 16 is old enough to have an opinion that others should be listening to. What are the circumstances that permit us to disregard a child's wishes?

The child in the OP was 16 months not 16 years old.

Thanks, I missed that.

In the instant case, there would be no question, then, that medical care should not have been denied.

How does one deal with a case where the case is a lot less clear-cut? Where it doesn't seem as though the patient is making their decision entirely independently and/or rationally, but there aren't enough obvious reasons to definitely say that they're pressurised/suffering from mental illness? Does one have to accede to their wishes anyway?

"Treat the patient, not the disease."

Yeah,on my sweet 16 I was in the state hospital,and needed to be there.You don't know jack at that age.I was dumb and naive as a box of rocks.And mentally ill.

This is a question that doctors begin to study in medical school, and don't stop studying until we retire.

Your last question is the most important. All other things being equal, one must always accede to a patient's wishes. The study of medical ethics is, in many ways, the study of when it is ethical to ignore a patient's wishes.

With a child, the answer depends upon numerous factors: the nature and gravity of the illness, the prognosis, the likelihood of successful treatment, the consequences of treatment and the likelihood of negative outcomes, the age and maturity level of the child, the nature of the objection to treatment, the patient's independent confirmation of objection and expression of a reasonable basis for that objection, the degree of influence demonstrated by guardians, and the list goes on.

At the end of the day, in my jurisdiction, when a doctor believes that medical care is necessary, and the child's objection is doubtful, that is the point that we call in the Public Trustee. The Public Trustee can authorize medical treatment over the objections of parents, or over the objectives of a mentally incompetent patient.

But if the child's objection to treatment is bona fide, clearly expressed, with an awareness of the likely results of withholding treatment, and all the other factors that we look for, then we stand back. I have gone so far as to sign a DNR for a teenager on this basis. It's an incredibly rare scenario, but it is not unprecedented.

Are there any WP members who belong to faiths that reject medical care in place of prayer? If so, I'd like to hear their opinions.

-Bill, otherwise known as Kraichgauer