Ethics Projects by Cecilia Reyes https://padlet.com/ceciliareyes6/rym0rm1lupx73r06 Should doctors have the power to report parents to CPS if the parent chooses to opt out of treatments for their terminally ill child? en-us 2021-11-29 16:42:51 UTC 2021-12-15 06:00:52 UTC hello@padlet.com https://journalofethics.ama-assn.org/sites/journalofethics.ama-assn.org/files/2018-06/hlaw1-0810.pdf ceciliareyes6 https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918417725  Unilateral Termination of Life-Sustaining Treatment in Neonatal Care: A Legal Overview ]]> 2021-11-29 16:48:08 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918417725 Pediatric-end-of-life decisions when abuse is suspected francescalazzarini https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918438968 2021-11-29 16:55:49 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918438968 In favor ceciliareyes6 https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918454914 - In states that permit law-enforcement officers or physicians to take temporary protective custody of a child at risk for abuse or neglect (Illinois and Iowa, for example), a physician may be able to gain custody of an infant if he or she believes the parents are not acting in the baby’s best interest.
- Judicial decisions have been inconsistent and potentially unethical, several state legislatures have enacted statutory guidance. Maryland, Virginia, and Texas have all passed statutes that attempt to address the unilateral removal of life sustaining medical treatment. 
- TADA clearly defines procedures for the physician, surrogate, and judicial system to follow when resolving impasses over termination of life-sustaining medical treatment.]]> 2021-11-29 17:02:01 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918454914 STATS: The national rate of child maltreatment was 12.1 per 1,000 children under age 18. According to the most recent national statistics available (from 2006), an estimated 3.6 million reports of suspected maltreatment were received by state CPS agencies, of which approximately 905,000 were substantiated chrystalvath https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918459068 2021-11-29 17:03:38 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918459068 Against ceciliareyes6 https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918460793 -  In some cases, the surrogate did not seek legal intervention, the physician unilaterally withdrew life-sustaining treatment without the permission of the surrogate, and the infant died. The recourse for the surrogate is to sue for damages in a tort claim or file a medical malpractice claim

]]> 2021-11-29 17:04:18 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918460793 General Information ceciliareyes6 https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918465326 - Once the primary physician makes it clear to the infant’s surrogate that he or she is unwilling to continue aggressive life-sustaining treatment and intends to withdraw it, several courses of action are available.
 -The physician can attempt to gain custody of the child in states that have temporary protective custody statues.
- A statutory process may exist to handle the dispute, or, if the physician withdraws treatment unilaterally, the surrogate can attempt to punish the physician through retributive litigation. ]]> 2021-11-29 17:06:05 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918465326 AGAINST: It is not the physician’s responsibility to determine the intent of the parent or caregiver, or whether abuse or neglect occurred. Their responsibility is to report their suspicions and allow trained professionals to conduct an investigation. chrystalvath https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918465333 2021-11-29 17:06:05 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918465333 IN FAVOR: Physicians may reduce their decisional burden and increase appropriate reporting by participating regularly in continuing education related to child maltreatment, familiarizing themselves with reporting laws and local CPS staff, and consulting with colleagues chrystalvath https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918471282 2021-11-29 17:08:30 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918471282 Important Info ceciliareyes6 https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918473510 "As long as the physician did not make unrealistic promises and clearly described the consequences of the action he or she was about to take, he or she is unlikely to be found legally liable to the surrogate for the death of the baby"
"In 1999 the American Medical Association adopted an opinion detailing the ethics of futile care. The Texas legislature incorporated much of that opinion in the Texas Advance Directives Act (TADA).]]> 2021-11-29 17:09:17 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918473510 ceciliareyes6 https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918475504 2021-11-29 17:10:05 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918475504 https://journalofethics.ama-assn.org/article/limiting-parents-rights-medical-decision-making/2006-10 abigailvang2 https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918545593 2021-11-29 17:37:27 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918545593 Information abigailvang2 https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918554475 - The provision of medical treatment hinge on the types of objection. As in of religious or secular, proposed treatment, and with or without treatment. 
- Legal competence involves the factor of making the most appropriate decisions. 
- Court would be weighing parents interest of the child and its outcome of illness/disease. ]]> 2021-11-29 17:40:53 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918554475 In favor abigailvang2 https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918554927 The parents decision of finding treatment elsewhere. As in a church instead of the usage of painful medical treatments.

]]> 2021-11-29 17:41:05 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918554927 GENERAL INFO: Neglect is the chronic failure to meet a child’s basic needs—clothing, nutritious food, cleanliness, educational opportunity, medical and dental care, protection, shelter, and supervision chrystalvath https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918554951 2021-11-29 17:41:05 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918554951 Against abigailvang2 https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918555284 - States do the need to protect its citizens, but parent rights are granted to people by the First Amendment to the Constitution. 
- Courts uphold the decision of parents from the highly medical needed treatments and the intervene parental decisions.
- Nonreligious objections gain parental refusal of treatment. Parents have more flexibility in choosing treatments.]]> 2021-11-29 17:41:13 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918555284 in favor francescalazzarini https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918556096 Parents’ rights are not absolute and may be removed in limited circumstances, particularly when their actions place the child at risk of harm.]]> 2021-11-29 17:41:33 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918556096 against francescalazzarini https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918556584 medical teams should make decisions based on the patient's best interest, not according to the secondary consequences for the family or the suspected cause of injuries. ]]> 2021-11-29 17:41:43 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918556584 general francescalazzarini https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918557174 medical teams must weigh two competing ethical principles : parental authority to make medical decisions and the patient's best interest.]]> 2021-11-29 17:41:56 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918557174 direct quotes/text francescalazzarini https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918558156 The American Academy of Pediatrics  recommends that a guardian ad litem be appointed “in all cases of child abuse requiring life-sustaining medical treatment in which a parent, guardian or prosecutor of the alleged abuser may have a conflict of interest”. A guardian ad litem does not assume medical decision-making authority, but serves instead as an unbiased but compassionate advocate for the child’s best interests. In most states, the guardian collects information about the child’s medical status, reviews law relevant to the circumstance, and makes a recommendation to the judge. Ultimately, a judge makes the final decision regarding withdrawal of life-sustaining treatment.]]> 2021-11-29 17:42:20 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918558156 stats francescalazzarini https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918558596 there aren't any stats in this article. it talks about the decision process of removing the parent's authority to make decisions for their child. ]]> 2021-11-29 17:42:29 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918558596 DIRECT QUOTES: "The level of suspicion required to report suspected abuse is not clearly defined" chrystalvath https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918569276 2021-11-29 17:46:39 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1918569276 Text/Quotes abigailvang2 https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1919869531 "…the spiritual treatment exemptions reflect, in part, “the policy of this State with respect to the quality of life” a desperately ill child might have in the caring and loving atmosphere of his or her family, versus the sterile hospital environment demanded by physicians seeking to prescribe excruciating, and life-threatening, treatments of doubtful efficacy [3]." To explain this importance, it shows there's several factors of treatment success rates. It takes notice in all the information and life components to the patient.]]> 2021-11-30 08:30:11 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1919869531 Stats abigailvang2 https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1919870146 There is 50% or higher of success for treatment process. The State would then justify for custody of a child. ]]> 2021-11-30 08:30:36 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1919870146 francescalazzarini https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1925561221 2021-12-02 16:24:18 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1925561221 About the article francescalazzarini https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1925595486 This article talked about the liability physicians have to report suspected child abuse. It gave specific examples of court cases such as Landeros v. Flood and Becker v. Mayo Foundation. In The Landeros v. Flood case whether Dr. Flood provided sufficient care for his patient was argued as well as his failure to report suspected child abuse. The article also talked about how all states have mandatory child abuse reporting laws, whether a physician is civilly liable rather than for negligence or malpractice varies from state to state. For example, in Becker v. Mayo Foundation the civil liability for failing to perform a statutory duty and the child abuse reporting statutes were not allowed to be introduced since Minnesota didn't have those laws. ]]> 2021-12-02 16:38:13 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1925595486 https://journalofethics.ama-assn.org/sites/journalofethics.ama-assn.org/files/2018-06/cprl1-0902.pdf chrystalvath https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927874128 2021-12-03 17:50:42 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927874128 Journal 2- https://journalofethics.ama-assn.org/sites/journalofethics.ama-assn.org/files/2018-06/hlaw1-1007.pdf ceciliareyes6 https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927874958  Legal Restrictions on Decision Making for Children with Life-Threatening Illnesses—CAPTA and the Ashley Treatment ]]> 2021-12-03 17:51:12 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927874958 https://journalofethics.ama-assn.org/sites/journalofethics.ama-assn.org/files/2018-06/pfor1-0610.pdf chrystalvath https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927884025 2021-12-03 17:56:33 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927884025 IN FAVOR: Parental resistance to immunizations put communities in danger as a whole. As a result, it is important for doctors to report refusal to proper medication. chrystalvath https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927889436 2021-12-03 17:59:34 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927889436 In Favor ceciliareyes6 https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927893838 - physicians, parents, or other decision makers who are considering palliative measures rather than medical treatment or resuscitation on behalf of pediatric patients should be aware of federal and state statutory and case law that may restrict their decision.
- a state’s child protective services must have and exercise the authority to initiate legal proceedings to prevent medical neglect and to provide medical care or treatment for a child when necessary to prevent or remedy serious harm to the child.  
- The CPS agency sought temporary custody and petitioned family court for a decision regarding AMB’s best interests 
- federal and state statutory and case law imposes significant restrictions on the decision-making authority of parents and physicians. 
- CAPTA grants must restrict the withholding of medically indicated treatment from disabled infants with life-threatening conditions unless...
(1) the infant is chronically and irreversibly comatose
 (2) the treatment would merely prolong dying
 (3) the treatment would be virtually futile in terms of the survival of the infant ]]> 2021-12-03 18:02:17 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927893838 AGAINST: Doctors often hesitate to report parents who refuse their children's immunizations as they may interfere/offend someone's religion. This causes some officials to go against reporting as they are afraid of belittling someone's morals/beliefs. chrystalvath https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927894277 2021-12-03 18:02:31 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927894277 https://journalofethics.ama-assn.org/article/choosing-alternative-treatments-children/2011-06 abigailvang2 https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927894542 2021-12-03 18:02:41 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927894542 GENERAL: Areas with less immunization rates often have higher rates of sickness as well due to herd immunity: resistance to the spread of an infectious disease within a population that is based on pre-existing immunity of a high proportion of individuals as a result of previous infection or vaccination. chrystalvath https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927897054 2021-12-03 18:04:07 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927897054 Against ceciliareyes6 https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927900186  -Parental preference for palliative care is often honored when the benefits of continued treatment are uncertain and the burdens of medical treatments and the illnesses themselves seem great 
 -the hospital had violated state law and Ashley’s constitutional and common law rights by performing the hysterectomy without a court order ]]> 2021-12-03 18:05:46 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927900186 DIRECT QUOTES: "Parental refusal has been implicated in the development of 'hot spots': locations where the herd immunity provided by compulsory vaccination has been weakened sufficiently for disease outbreaks to occur." chrystalvath https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927902794 2021-12-03 18:07:21 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927902794 STATS: 500 cases and 7 fatalities were traced to unvaccinated families (including children). chrystalvath https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927904479 2021-12-03 18:08:21 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927904479 General Information ceciliareyes6 https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927909744 -Palliative care should provide comfort and and an increased quality of life for terminally ill patients rather than providing a cure or prolong life. 
-Most states have adopted federal government regulations of requirement's for states that receive grants under the Child Abuse Prevention and Treatment Act.]]> 2021-12-03 18:11:30 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927909744 Important Facts ceciliareyes6 https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927915177 -" Two important examples of legal restrictions on decisions involving pediatric palliative care are the federal Child Abuse Prevention and Treatment Act of 1996 (CAPTA) and Constitutional and case law restrictions on sterilization surgery such as the Ashley Treatment in disabled children."
-" Under CAPTA, failing to provide appropriate nutrition, hydration, and medication to any infant with a life-threatening condition always constitutes “withholding of medically indicated treatment.” 
-" The same holds true for failing to provide such an infant with a treatment that, in the physician’s reasonable medical judgment, is most likely to ameliorate or correct the condition" ]]> 2021-12-03 18:14:40 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927915177 ceciliareyes6 https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927917283 2021-12-03 18:15:55 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927917283 About abigailvang2 https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927928435 In this article, it informs about how the rejection of a treatment has to have a worthy decision capacity about the child's medication/pathway.]]> 2021-12-03 18:22:15 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1927928435 In favor abigailvang2 https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1928056686  In the Neumann case, doctors should have the rights from the parents being so involved with religious factors that they don’t seek medical help at all. ]]> 2021-12-03 19:43:09 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1928056686 Against abigailvang2 https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1928056964 In the Re Hofbauer case, the medical treatments the parents chosen helped improved the child’s disease/condition. ]]> 2021-12-03 19:43:20 UTC https://padlet.com/ceciliareyes6/rym0rm1lupx73r06/wish/1928056964