 |  susy, 4 years old female child
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| Author | 7 Posts |
vyseerx
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susy 4 years old female child was brought with compliants of fever for 2 days. on enquiry the child has told it hurts while passing urine.urine microscopy has shown 10-15 wbc/hpf, and glucose ++. no protien.urine culture was reported sterile. a diagnosis of IDM has made. physician has told the diagnosis to the parents, and explained the need for regular insulin injections and the education for parents regarding treatment. parents were deeply religious and after a long discussion among them selves, they told , they will take the child home and pray. what should the doctor do?
a.honor their wish
b.admitt the patient for treatment, despite protests from parents
c.obtain the legal guardianship from court
d.refer to the ethics committee of hospital
e.resign from the hospital
f.refuse to be their doctor
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vyseerx
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| TONY PAUL
Forum Junior
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another great question..and I know the answer will be either B or C, so I will go with answer C..obtain the legal guardianship from court
not picking B, because DM is going to be long term and parents won't give her insulin.
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| asmi
Forum Hero
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B..
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| vyseerx
Forum Guru
Topics: 165
Posts: 378
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here, it is clearly evident that parents are not acting in the interests of the child. one of the rules regarding ethics questions is PARENTS CAN NOT REFUSE LIFESAVING OR LIMBSAVING TREATMENTS FOR THEIR CHLDREN. period. however, we must realise that here IDM diagnosis is made. not a diagnosis of DKA. DKA is a medical emergency and with out prompt treatment child would die. so, if DKA was the diagnosis , B would have been the answer. now since IDM is as such not lifethreatening, doctor can OBTAIN LEGAL GAURDIANSHIP from court and then proceed with treatment. C is the clearcut answer
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| vyseerx
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sorry guys, instead of typing PARENTS CAN NOT REFUSE LIFESAVING OR LIMBSAVING TREATMENTS FOR THEIR CHILDREN, i have typed they can not save the treatmetn............ SORRY FOR THIS.
correct thing is , i rieterate, PARENTS CAN NOT REFUSE LIFESAVING OR LIMBSAVING TREATMENT FOR THEIR CHILDREN.
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| son64
Forum Elite
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What do you mean?IDM Plus UTI will shortly progress to DKA and Septic shock unless promptly treated as an emergency.So the doc should proceed with out informing the court.
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| vyseerx
Forum Guru
Topics: 165
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court order can be obtained in a matter of few hours, if the need be. diabetes mellitus even with urinary tract infection will NOT progress to diabetic ketoacidosis in few hours. as a practising pediatrician for 10 years , i can vouch for this.by the way, here the diabetes mellitus is diagnosed for the first time. contrary to the adult presentation with polyuria, polydipsia, and polyphagia, in children it presents with a urinary tract infection. please note.
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vyseerx
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