Do parents or guardians elect to abandon effective care when the child's condition is serious or life-threatening? |
Courts are likely to respect parental or guardian choices that are supported by some medical authority and that present reasonable alternatives as long as the child's life is not in danger and conventional care is not imminently necessary. The child's condition should be monitored so that conventional interventions can be used if necessary. |
Will the use of complementary therapy otherwise divert the child from imminently necessary conventional treatment? |
If not, a "time-limited" trial of the proposed approach may be appropriate[1,2], provided that the child can be monitored conventionally and conventional therapy can be continued as appropriate[3,4]. |
Are the complementary therapies that have been selected known to be unsafe or ineffective? |
The medical evidence can be categorized as follows, with increasing risk of liability[3]:
|
The clinician caring for the patient should continue to monitor the patient and the literature for new information that would change the category. |
Have the proper parties consented to the use of the complementary therapy? |
Informed consent is particularly important when informing the patient about complementary therapies that may affect the patient's choice of treatment[5]. |
Is the risk-benefit ratio of the proposed complementary therapy acceptable to a reasonable, similarly situated clinician, and does the therapy have at least minority acceptance or support in the medical literature? |
Adapted from: Cohen MH, Kemper KJ. Complementary therapies in pediatrics: A legal perspective. Pediatrics 2005; 115:774.
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