Treating team uncertain about the appropriate care pathway | A 9-year-old boy has an inherited blood disorder and a range of other comorbidities. His family is also experiencing difficult social circumstances that are having an impact on his care. Clinicians are unsure whether offering a bone marrow transplant is appropriate. |
Parents disagree with treating team's recommendations | Jehovah's Witness parents request a different form of surgery to that recommended by the treating team for their 4-year-old daughter. The parents’ preferred surgery does not require a blood transfusion but has a lower probability of restoring full mobility to the child's severely injured leg, and will mean further surgeries for her in the future.24 |
Family members disagree with one another about treatment options | Separated parents disagree with each other about withdrawal of treatment for their severely disabled, ventilator-dependent 2-year-old daughter. The treating team's view is that withdrawal of treatment would be appropriate if both the parents agreed. |
Adolescent/potential mature minor disagrees with treating team's recommendations | A 15-year-old has a suspected recurrence several months after completing cancer treatment, which included radiation and chemotherapy. She is declining the recommended diagnostic testing and has indicated that she wants to pursue alternative treatment exclusively. |
Child is resisting treatment | A 7-year-old boy with a chronic condition requires long-term oral medication. He has a long history of refusing medications, despite multiple strategies tried by his parents and doctors. His doctors are considering inserting an intravenous port or a tube into the patient's stomach to enable administration of medications. |