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Conflict between Parents

Children can be pawns in marital battles. This becomes an issue in medical care if the child is being abused or if the parents disagree on medical treatment for a child. As discussed in Chapter 20, suspected child abuse must always be reported to child protective services. If the disagreement over medical care threatens to escalate into neglect or physical harm, this must also be reported to child protective services.

The most difficult cases are those involving disputes over elective care. Legally, consent from one parent is sufficient. When the child is too young to have an independent opinion, the physician may choose to treat the child based on the consent of one parent. If the physician has been refused consent by one parent, it is less clear that the physician may then seek consent from the other parent. Children who are mature enough to have an independent opinion should also be consulted. If the child and one parent agree on a medically reasonable course, the physician should follow that course. Conversely, since physicians should not force unwanted care on a mature minor in general, they should be especially reticent to do so if a parent agrees with the minor.

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