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400870 Population Health And Society Question: What happens when parents and children have conflicting opinions about treatment?   Can a parent refuse lifesaving medical treatment for his/her child? Why or why not, explain your position.   How old does a child have to be to make their own medical decisions? Explain why you agree or disagree.   Can healthcare professionals override parental decision to withhold medical treatment? Should healthcare professionals be able to override parental decisions to withhold medical treatment?   Should parents be allowed to refuse medical treatment for their child?   Should minors be allowed consent to follow the services without parental notification: contraceptive services, testing and services for HIV and other sexually transmitted diseases, prenatal care and delivery services? What about treatment for alcohol and drug abuse, or mental health care? Answer: Introduction:  While the law has traditionally considered minors to be incompetent in giving consent for the medical treatment for the disease, many countries even states have designed policies and legislative framework for giving minors the authoritative position for consent to treatment in the specific situation in the health care sector (Neal & Hammer, 2017). It is a well-established principle that before treating any patient, physicians in the clinical setting obtain consent from the patient for specific treatment. However, the conflict often arises considering the authoritative position for giving the consent to the treatment. The prime reason behind it is that although the parents can legally give consent to the treatment, many minors refuse to participate in the treatment procedures that further hinder the effective treatment procedure (Breakwell, 2015). Furthermore, conflict also regarding consent for treatment of the minors who have divorced parent and parent share custody (Arnold & Boggs, 2015)..Therefore, this paper would argue about the importance of the minors in giving consent to the treatment procedure. Discussion: The Consequence Of Conflicting Opinions Between Children And Parent: It is a well-established concept that many minors have the capacity to make the right decisions for their health care services. Since the federal government of United States revises the laws involving minors for the health care services, giving priorities to the minors while conducting treatment procedure is crucial for every health professional in order to conduct order effective recovery-oriented treatment services.  Parents and physicians should not exclude children from the decision of treatment procedure. In the viewpoint of mine, there are negative consequences of conflict of opinion about the treatment. A study by Berkman et al. (2015), suggested that since the psychic makes up of the children is sensitive, the perspective of the children understanding the conflict is different from the perspective of parents understanding the conflict that is influenced by the hostile relationship between parents, poor parenting practice, the separation between parents and negative parent-children relationship. Therefore, the majority of the cases, minors feel threatened due to conflict of opinion regarding the treatment procedures (Neal & Hammer, 2017). In the clinical setting, the consent to the treatment is generally given by parents without asking for the consent of children (Arnold & Boggs, 2015). Therefore, in my opinion, the conflict of opinion regarding treatment influenced the mental health of minor such as infants and teenagers. According, the consequence of the conflict of opinion between parents and children give rise to mental health issues such as anxiety, depression and eating disorders. According to Parker (2014), it was observed that in the clinical setting, due to the major conflict, children refuse to participate in the treatment procedure that worsens the health condition. Generally, the consequences are non-violent but the expression of aggression and self-harm is evident in specific treatment (Arnold & Boggs, 2015). Another studyJanicke, Fritz and Rozensky(2015), females are more prone to depression due to the conflict regarding treatment. Therefore, to conclude, in order to reduce the conflict and managing the consequences of the conflict, the involvement of children in the decision-making should be integrated with the health care services. Parents Refusing The Life-Saving Treatment For The Children: Children are a largely ignored group in the medical ethics where it concentrated in the adult with capacity for taking the right decision for the treatment which children (Carr, 2015). According to the government legislation, for the best interest of the children, the parent should not refuse life-saving medications since it can lead to premature death (Janicke, Fritz&Rozensky, 2015). However,   in my opinion, parents have rights to refuse the life-saving treatment for their children only. Accumulated evidence exhibited different dynamics where parents refuse life-saving medications for the treatment of children (Neal & Hammer, 2017). According toHarris (2015),many life-saving medications for the adults are not suitable for the children and application of these treatment procedures might lead to negative consequences. Therefore, many parents become apprehensive about the well-being of children and refuse to provide consent for the treatment. Another study byAlpern et al. (2017), suggested that since the life-saving medications are higher expensive, many parents are not able to afford it, especially who are single parents or separated from the spouse. Therefore, they refuse to provide consent for life-saving medication even if it is the best treatment for saving the life of the sick child.Janicke, Fritz and Rozensky(2015), argued that, due to episodes of negative experience and falls beliefs influenced by the culture and society, parents become apprehensive about the life-saving medications because of their negative consequences. They feel that they the life saving treatment will harm their child or any other negative consequences which will lead to premature death (Carr, 2015). Therefore, they belief in traditional treatment procedures which will save the life of their children and they refuse to give consent for the life-saving medications even if it is the only treatment that saves the life of the child (Neal & Hammer, 2017). Therefore, to conclude, in order to reduce the probability of the refusal of life-saving medications by parent, proper awareness should be raised through appropriate educations and campaign programs, health care expenses should be reduced by legal policies and legislation. Moreover, making  children the center of the decision making , manufacturing of  proper life-saving medications should be designed which would-be suitable for children is also effective for reducing the issue (Arnold & Boggs, 2015) Justification Of Allowing Minors To Participate In Healthcare Decision Making: Children who belong to the age group of fourteen to seventeen years of age are allowed to undertake their own decisions about health and recovery options (Stanford & Connor, 2014). This can be termed as ‘consent’ and is legally permitted by the law. According to my perspective, the age group between fourteen to seventeen years is extremely sensitive and at the same time vulnerable. It characteristically marks the transition to adulthood. Studies reveal that, the transition from adolescence to adulthood marks a series of hormonal and physiological changes that is characterized by emotional and psychological conflicts. Further, it has also been mentioned in this regard that adolescents are likely to act according to their free will and acting according opposite to it might lead to negative implication on the psychological wellbeing of the patient. Research studies further reveal that, the terminal adolescent phase marks adulthood round the corner and it is increasingly important to prepare the teenagers to manage responsibilities related to healthcare (Brierley &Larcher, 2016). Further, healthcare forms an integral aspect of their lives and seeking their consent before proceeding with a treatment regimen is important to ensure that they are comfortable with the devised treatment procedure. The opinion of the teenagers are given vital importance in association to making healthcare choices, extending consent for a treatment and choosing a new care provider or considering a second medical opinion. I strongly feel, that the age is appropriate to educate teenagers about complex disorders that might affect their physical health. Awareness helps in rendering teenagers with self-management strategies so that they can assume an active role in managing their personal care. In addition to this, it should further be stated that by the age of seventeen adolescents must acquire knowledge about the importance of medical history while going for a treatment process. Also, teenagers must be familiar with the idea of being placed under the care of a primary care doctor. In addition to this, minors must also develop an idea about the places that can ideally provide details about medical records. The concept of health insurance, medical coverage and its associated limitations should also be made known to the minors, in order to ensure that they have a sound idea about the functioning of the healthcare system. Healthcare Professionals And Their Ability To Override Parental Decisions: It is important to note in this context, that caring for minors require healthcare professionals to adapt a family-centred approach throughout the process of treatment intervention (Cregan, 2013). This is exclusively because, children below the age of seventeen years do not possess knowledge and the reasoning ability to comprehend with the medical health condition and at the same time provide their consent for the treatment process. In order to address these issues, the decisions are widely taken by the immediate care providers of the children who are either the parents or the local guardians of the children. Health care professionals and care providers of the children work in partnership to impart effective care to the children. However, numerous instances indicate possibilities when the parents of the children refrain from continuing the medical treatment procedure for their children. A number of factors can be accounted for the decision that includes, financial crisis, societal barrier or other allied reasons. In these circumstances, care providers often assist healthcare professionals to withhold medical treatment and the recovery of the child is at stake. In order to address such critical scenarios health care professionals are fairly equipped with certain strategies to prevent the advent of such instances. These strategies are known as ethical principles and require the healthcare professionals to recognize the dignity and intrinsic value of the children and their right to receive medical treatment and protection. Also, even though the family issues form an important aspect of consideration, the care professionals must act in the best interest for the welfare of the child and the adolescent. The care professional must consider the expectations of the children and at the same time avoid bias and advocate in favour of the minor and improve their access to healthcare facilities (Ruhe et al., 2016). Reservation Of Parents In Refusing Medical Treatment To Children: According to my perspective, it is correct on the part of the healthcare professionals to intervene and oppose the decision of the parents to withhold a particular treatment routine. It should be noted in this context, that the decision to withhold the treatment might be due to societal stress, financial stress or any other reason and is definitely against promoting wellness in the child. Therefore, it is important for the professionals to act in their best interest and adapt necessary measures to ensure them a secured life with underlying values of dignity and respect. In fact, the right could end up saving the life of a child which is the ultimate goal of the carer who works a health care professional. Further, the decision making ability of the healthcare professionals could also help in convincing the parents and acquire positive patient outcomes. As has already been discussed in the previous paragraphs, the parents are granted the moral and the legal right to take medical and health related decisions for the welfare of the child. This is because, children up to the age of sixteen do not possess the maturity to make complex decisions for themselves while seeking medical intervention. Parents are assured the right to refuse or discontinue life-sustaining treatment or accept and continue the treatment process for the welfare of the child. However, studies reveal that parental decisions might turn out to be biased or influenced by extrinsic factors and hence, to regulate such situations, the decisions are guided by the healthcare professionals so as to serve the best interests of the child. It should be mentioned in this regard that the medical caretakers possess the authority to challenge the decision of the parents if it is found to be detrimental for the health and welfare of the child. The basis of granting guardians and parents the right to take decision for the children is exclusively based on the familial ties that the child shares with the members of the family since birth. The home forms the first environment of the child and the family members are supposed to be critically aware about the needs of the child on the basis of the developmental considerations. However, instances that portray imprudent, neglectful or abusive approach towards the child while undertaking a vital decision for the health and wellbeing of the child is questionable by the medical authorities. It should be noted in this context that, instances that portray significant risk of harm towards the child must be challenged by the healthcare professionals. The care professionals must act as advocates to promote a secure life to the children and discourage the progression of any unhealthy decision. Care professionals should attempt to reach at a satisfactory resolution with the help of respectful decisions and ethical considerations (Snelling, 2016). Care professionals must be able to properly show both the aspects of continuing or discontinuing the treatment and even then if a satisfactory conclusion is not achieved then the professionals must consider the involvement of the state child protection agency or a court order (Khoo et al., 2017). The ultimate motto should be to save the life of the child and advocate the right to survival. Consideration Of Minors Under Specific Circumstances: The transition to adulthood marks fervor of the spirit of experimentation that makes teenagers involve themselves in a lot of misleading comfort activities that might lead to be troublesome for the health of the people. Adolescents, do not feel comfortable discussing about problems such as HIV testing, contraceptive services, sexually transmitted diseases, unwanted pregnancy and prenatal delivery and care services with their parents. This is primary because teenagers do not feel comfortable discussing about these problems with parents as parental attitude regarding these elements have been associated with dominance and critique. In addition to this, seeking treatment for alcohol or drug abuse should also be allowed without parent notification. Research studies state that more than 50% of teenagers end up suffering more complications due to inadequate assistance from care professionals for the fear of making parents aware about the condition (Yu et al., 2017). Negative behavioural trait of the parents thus leads to lack of access to healthcare facilities.  Healthcare facilities should be equally accessible to minors as well as adults irrespective of their social status so as to promote quality patient outcomes. However, legislative makers have refrained from designing policies to make it legal for the minors to access reproductive healthcare services and abortion services without parental notification in certain low income to middle income nations (Khoo et al., 2017). Authorization of minors to access healthcare facilities lead to easier access to intervention opportunities and thus saves possibilities of encountering a critical complication that might rise due to non-reporting of the condition. It is important to recognize the medical health needs and expectations of the minors and frame policies to work in favor of their interest. Conclusion: Hence, to conclude, it can be stated that the involvement of minor and adolescents within the decision making framework is an important aspect of ethical consideration. It should be noted in this context the parents are generally assured the legal right to undertake health-related decision for the welfare of the minors. However, the parental decisions can be affected by a number of extrinsic factors that end in taking a decision to discontinue a treatment process. In such circumstances, the healthcare professionals can challenge the decision of the parents and are expected to act in the best interest of the child and secure their right to survival. It should also be noted that minors might be assured legal rights to access HIV testing, Pre-natal delivery and care, contraceptive services and substance abuse treatment without having to notify their immediate parents so that they can be guaranteed unbiased services. References: Alpern, A. N., Gardner, M., Kogan, B., Sandberg, D. E., &Quittner, A. L. (2017). Development of health-related quality of life instruments for young children with disorders of sex development (DSD) and their parents. Journal of pediatric psychology, 42(5), 544-558. Arnold, E. C., & Boggs, K. U. (2015). Interpersonal Relationships-E-Book: Professional Communication Skills for Nurses. Elsevier Health Sciences. Berkman, L. F., Liu, S. Y., Hammer, L., Moen, P., Klein, L. C., Kelly, E., …& Buxton, O. M. (2015). Work–family conflict, cardiometabolic risk, and sleep duration in nursing employees. Journal of occupational health psychology, 20(4), 420. Breakwell, G. M. (2015). Coping with threatened identities. Psychology Press. Brierley, J., &Larcher, V. (2016). Adolescent autonomy revisited: clinicians need clearer guidance. Journal of medical ethics, medethics-2014. Carr, A. (2015). The book of child and adolescent clinical psychology:  Cregan, K. (2013). Who Do You Think You Are?: Identity and Childhood in Australian Healthcare Ethics. Cambridge Quarterly of Healthcare Ethics, 22(3), 232-237. Janicke, D. M., Fritz, A. M., &Rozensky, R. H. (2015). Healthcare reform and preparing the future clinical child and adolescent psychology workforce. Journal of Clinical Child & Adolescent Psychology, 44(6), 1030-1039. Khoo, E. J., Schremmer, R. D., Diekema, D. S., & Lantos, J. D. (2017). Ethics rounds: Ethical concerns when minors act as standardised patients. Pediatrics, e20162795. Neal, M. B., & Hammer, L. B. (2017). Working couples caring for children and aging parents: Effects on work and well-being. Psychology Press. Parker, I. (2014). Discourse dynamics (psychology revivals): Critical analysis for social and individual psychology. Routledge. Ruhe, K. M., De Clercq, E., Wangmo, T., &Elger, B. S. (2016). Relational capacity: Broadening the notion of decision-making capacity in paediatric healthcare. Journal of bioethical inquiry, 13(4), 515-524. Snelling, J. (2016). Minors and Contested Medical-Surgical Treatment: Where Are We with Best Interests?. Cambridge Quarterly of Healthcare Ethics, 25(1), 50-62. Stanford, C. C., & Connor, V. J. (2014). Ethics for health professionals. Jones & Bartlett Learning. Yu, B., Wijesekera, D., & Costa, P. C. G. (2017). Informed Consent in Electronic Medical Record Systems. In Healthcare Ethics and Training: Concepts, Methodologies, Tools, and Applications (pp. 1029-1049). IGI Global.

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