Pediatria pre prax 1/2020

Parents have refused consent treatment of their child with cancer: how to act?

Background: Pediatric oncologists are often faced with situations in which parents or guardians refuse recommended treatment for curable childhood cancer. Deciding how to proceed in such situations is an ethical dilemma. The aim of this article is to consider optimal approaches when parents are strongly opposed to oncological treatment, potentially compromising their children’s rights to health care and to the chance for cure. Cases: Here we report a case of treatment refusal from our department and the impact of such decisions on the child. The case describes a patient with a primary lymphoma of bone who received treated by court order after parental refusal. Conclusion: The reasons for refusing treatment vary. The entire medical team is tasked with trying to respectfully understand the reasoning behind the parents‘ unwillingness to accept treatment, in order to address all possible misunderstandings and to propose a solutions, that could be acceptable to the parents. In some situations, however, it is necessary to resolve the dilemma by legal means in order to protect the life of the child.

Keywords: pediatrics, oncology, ethics, decision-making, parental permission, informed consent, medical law, Slovakia