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Introduction

Pediatrics, or more specifically, the medical care of children, is the most legally distinct of the medical specialties. This legal uniqueness has three threads. The first is consent to care. Children may not legally determine their own care, but neither are parents fully empowered to control their child's medical care. The second is communication with the physician. Very young patients are unable to communicate their medical needs to a physician effectively. Finally, childhood immunizations are the frontline in protecting society from epidemic communicable diseases. Immunization, with the potential risk of serious sequellae, creates a conflict between the child's individual medical care needs and the protection of society.

With the exception of intensivists treating neonates, the care of children is a legally low-risk endeavor. General pediatricians tend to get in trouble more for what they do not do than for what they do. This is to be expected in any area of medicine in which the vast majority of patient encounters are either preventive in nature or are for minor illnesses. Many of the cases in which pediatricians are charged with failure to diagnose a condition actually involve a systems failure in the physician's office routine rather than an error in medical judgment. As with all other physicians who have highly routinized practices, pediatricians must take special care to document all findings and ensure that atypical events are identified.


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