Evaluating Parental Refusal of Treatment: Thinking Beyond the Principles

While several frameworks including the harm principle exist for navigating cases involving parental declination of medically recommended treatment for their children, cases such as the one presented here may leave clinicians feeling without adequate guidance. Specifically, criteria including imminence, severity and scope of harm, and the balance of potential risks and benefits may not always lend themselves to clear answers. In such scenarios, it may be helpful to readjust the ways in which we utilize these frameworks and consider moving beyond them. This may include relinquishing more narrow definitions of imminence and harm, broadening perspectives, and incorporating additional context including patient narrative as part of the ethical analysis. Such expansion will necessitate careful awareness of the potential for unjust or inequitable implementation.