- Emergency medicine physicians provide medical care in a fiscally and ethically challenging environment. Care should be provided to anyone in need, regardless of immigration status or ability to pay.
- Physicians, patients, parents, and guardians share a common goal to protect the health and well-being of the child. In the event of a disagreement, every effort must be made to resolve conflicts to assure the best possible outcome for the child.
- No child should be denied medical care in the emergency department.
- Informed consent is the appropriate term for the process of reaching an agreement about medical care between a physician and a patient with full decision-making capacity and legal empowerment.
- Informed permission is the preferred term when a parent makes decisions for a patient lacking decision-making capacity or legal majority.
- Assent (or permission) of the patient is very important and should be sought whenever possible.
- Adolescents may be able to seek confidential and independent health care for a number of conditions defined by statute. Low-risk, high-benefit treatment may be provided if the physician believes the adolescent is as capable to consent as an adult.
- Treatment for an emergency medical condition should never be delayed if a patient is unable to provide informed consent or a parent or guardian is not present to provide permission.
- Family presence should be considered for all medical procedures and resuscitations.
- Despite a long history in medical education, practicing procedures on the newly dead is problematic. It should be done only with fully informed permission from a parent or guardian.
Medical ethics is a broad philosophical discipline that guides medical practitioners to act in the best interests of patients. Ethical conflicts may arise if there are differences of opinion about what those best interests might be. Many different approaches have been explored in detail, and many emergency medicine practitioners approach the discipline from different philosophical, moral, or religious viewpoints.1,2
Emergency medicine physicians are responsible for providing medical care in an increasingly fiscally and ethically challenging environment. Care is provided to anyone in need, regardless of immigration status or ability to pay. Emergency departments (ED) serve as an essential medical safety net; they are the only places in the United States where all patients are guaranteed medical care.3 This fundamental dedication to provide care to those most in need or with no other health care options is a core ethical value of emergency medicine.2
In the practice of pediatric emergency medicine, patients, parents, guardians, and physicians generally have a common goal: to act in the best interests of the child. The physician has an obligation to diagnose and treat illness, alleviate discomfort, and provide for as rapid a recovery as possible. With effective communication, an agreement can usually be reached and a diagnostic, therapeutic, and follow-up plan can be implemented. Sometimes disagreements arise, which, if unresolved, could jeopardize the health and well-being of the child. Significant effort may be required ...