Table 3

Potential harm thresholds for allowing parents to choose less effective treatment

Severity of harmExample harmsExample caseAcceptable probability of risk eventuating
Long-term disability
Refusing a vitamin K injection for a newborn could lead to clotting and has an increased risk of death30 Small <5%
MediumPainful procedure
Additional surgery
Short-term illness
Refusing a complete surgical repair of a broken leg (because it requires a blood transfusion) and instead opting for an incomplete repair, increasing the need for additional surgeries and the risk of surgical complications51 Medium <15%
SmallSomewhat painful procedure
Slightly increased length of illness
Refusing antibiotics for an ear infection may lengthen the duration of the illness52 Large <50%
TrivialVery short-lasting painEar piercing causes mild pain that quickly resolves53 Certain 100%