Balancing protection and respect in paediatrics

• Published in: Postgraduate medical journal Vol. 85; no. 1002; pp. 169 - 170
• Main Authors: Doyal, Len, Doyal, Lesley, Sokol, Daniel
• Format: Journal Article
• Language: English
• Published: England The Fellowship of Postgraduate Medicine 01.04.2009; Oxford University Press
• Subjects: Child; Child Advocacy - ethics; Child Advocacy - legislation & jurisprudence; Child Care - ethics; Child Care - legislation & jurisprudence; Children & youth; Humans; medical ethics; paediatrics; Parents & parenting; Paternalism; Personal Autonomy; Physician-Patient Relations - ethics
• ISSN: 0032-5473; 1469-0756
• DOI: 10.1136/pgmj.2008.076919

[...]a mature child suspected of having been physically abused by a parent may be unwilling to implicate them, despite compelling evidence. Because of their fear of separation from their parents, they may refuse to discuss the origins of their injuries (or provide unconvincing explanations) and may not consent to related diagnostic examinations. Some commentators, sometimes triumphantly called "child liberationists", argue that existing levels of respect for the autonomy of children in medical practice is far from acceptable and should be increased. 6 Others, sometimes called "child protectionists", argue that too much emphasis has been placed on the concept of autonomy to the potential detriment of children. 7 To provide a guide through such potentially troubled waters, Richard Beach and Rosalyn Props, consultant paediatricians at Norfolk and Norwich NHS Trust, have written an engaging paper (see page 181 ) based on their personal experiences and provide practical advice on how best to proceed, especially in the face of morally and legally indeterminate "hard cases".