Question

A 12-year child with a terminal diagnosis of sarcoma of the arm has a large suppurating wound that has a foul odor and drains constantly, damaging the surrounding skin. The wound is painful and requires painful dressings daily. Her life expectancy is 6 months to a year. A surgical procedure could remove most of the tumor and facilitate closing of the skin. The surgery would not improve the child’s prognosis or extend her life. It would reduce the pain, eliminate the odor, decrease or eliminate the dressing changes and allow better use of the affected arm. The child is refusing the surgery. The parents understand the hoped for improved quality of life and can see the benefit of the surgery. However, they are reluctant to approve the procedure since the child has had multiple other procedures and is afraid and doesn’t want the surgery. They are strongly considering allowing the child to make the decision.

What rights are in conflict and which right should prevail? What other information might you need to make a decision? What is the right (adjective) thing to do?

Answer 1

Ensure that the best decision are made for children and adolescents these decisions should be made joitly by members of the health team,with discussion of parents and the child,The decision making for the children and adolescens should be interdisciplinary and collaborative and should actively involve the family and when apropriate the child and adolescent,in the above case we should avail the surgery for the child, to alivate the sufferings, we should make understand the child and parents regarding the importance of the surgery, and make them covince.