Potential Legal Issues in Childcare

Educators encounter many ethical questions in their work with children and families. Each of the Focus on Ethics in Young Children columns presents an ethical question and asks our readers to understand how an early childhood educator might better respond. Every daycare must strive to create a healthy and safe environment for children, otherwise staff could face serious legal consequences. Ensuring that your daycare provides proper care and treatment will give children a safe place and give their parents peace of mind that their child will be cared for appropriately. With the exception of West Virginia, states do not allow a minor, even if legally emancipated, to create a legally enforceable living will, continuing power of attorney, or other declaration that he or she wishes treatment to be discontinued in the event of a critical illness or accident (Hawkins, 1992).17 This does not mean that the physician must not: know the child`s opinion on continuing treatment if the long-term prognosis is not good (AAP, 2000g). These views should continue to be taken into account in decision-making (In re Chad Swan, 569 A 2d 1202, Maine 1990). It is particularly important to address and address these issues when developing prevention efforts to avoid unintended consequences. The ethical and legal issues that must be considered when formulating a research agenda for child maltreatment studies fall into the following three categories: Ethics committees may also propose professional consensus on institutional guidelines for particular topics, such as DNR orders, and try to reach a professional consensus. In addition, committees usually have an educational role in teaching others that a related question of validity is associated with the reliability of children`s reports and testimony.

As noted in previous chapters, the accuracy and veracity of children`s accounts and the validity of psychological measures that would reveal abuse or neglect remain unresolved issues. In particular, the question of the reliability of adult memories of child abuse remains controversial. An important ethical issue that arises in many human studies is the ethical acceptance of randomly assigning research participants to experimental and control treatment groups. While random assignment is essential for scientific validity, it may be ethically impermissible if it means that the subject matter of the research is deprived of therapeutic or potentially life-saving intervention. This issue is particularly complex when a particular intervention is deemed effective enough that its restraint may amount to inhumane treatment (Kaufman and Zigler, 1992:279). Medical ethics goes beyond clinical practice to include legal obligations, relationships with other professionals, and societal responsibilities. For example, the American Medical Association`s Principles of Medical Ethics state, among other things, that physicians should report other physicians who have deficiencies in character or competence, and that, except in emergencies, they should be free to choose the patients they serve (AMA, 2001). It is now widely accepted among clinicians, ethicists, policy makers and the informed public that renouncing life support is often appropriate as death approaches (see Chapter 5). Despite this consensus, parents of a dying child may not accept a clinician`s assessment that life support no longer has the potential to benefit the child and may insist that it continue.

Much of the discussion later in this chapter focuses on strategies for understanding the reasons for a physician`s family rejection and resolving disagreements without harming the patient, family, or health care team. Although the federal certificate of confidentiality may prejudge state reporting obligations, legal opinions differ on this subject (Sieber, 1992a). Few researchers have received confidentiality certificates (Melton, 1990), and none have tested the appropriateness of such waivers to the mandatory reporting requirements of state child protection laws. Therefore, the prevailing practice is that researchers assume that confidentiality certificates or waivers are without prejudice to state reporting laws, and the informed consent process serves as a mechanism by which scientists warn research subjects of their reporting obligations. There does not appear to be a sanction for the researcher who testifies after receiving a certificate of confidentiality, but criminal sanctions exist for those who intentionally conceal evidence of alleged child abuse. Child victimization can be controversial or sensational, especially when it comes to sexual abuse. The potential legal liability of the research institution if emotional harm is inflicted on children or their families during the course of the research may result in strict requirements for researchers to demonstrate the need for the research, the validity of the research design, the appropriate selection of research topics and methods, and the careful handling of research data and interpretations, including privacy and confidentiality guarantees. While it is important to understand the ethical and legal context of decision-making, most disagreements about care are resolved informally through discussion and reflection. For example, the vignette on the Devane family in Chapter 3 describes how a teenager with recurrent cancer died by refusing another stressful experimental treatment (desired by her doctor and parents) and spending the time she had left doing what she wanted to do.

Conte, J. 1987 Ethical issues in the evaluation of prevention programmes. Child abuse and neglect. 11(2):171-172. Clinical practice guidelines or protocols represent a system-wide targeted strategy to provide a credible, authoritative, evidence-based framework for individual patient care decisions (IOM, 1990a, 1992). Procedures vary in rigour and credibility, and methods for developing guidelines continue to be discussed and refined. In general, stricter guideline development processes bring together clinicians, methodologists and sometimes consumers, ethicists and others to define the issues at stake, identify and evaluate relevant scientific evidence or facts, and make statements about appropriate care based on an explicitly described combination of evidence. clinical judgment and values.

But they may also discover and resolve issues with trust, fear, anger, or other emotions, including personality conflicts. The allocation of resources for medical care is only one element of a larger set of questions about the distribution of resources and responsibilities of the community. Families of critically ill or injured children often face heavy financial burdens, sometimes resulting in job loss, homelessness, bankruptcy and homelessness. Even if they have private health insurance, it usually doesn`t cover all home health care and non-medical home care and other services that a child and family may need. Medicaid and other governments – Regardless of children`s developmental stage or legal status, most high-profile litigation, regulations, and laws regarding end-of-life decisions are rare, but can create anxiety among clinicians that have the potential to skew the way doctors inform and counsel patients and families (see, e.g., Kopelman et al., 1988). Part of this fear and anxiety stems from a misunderstanding of laws, regulations, and court decisions, although some may also be due to excessive caution on the part of the hospital or other legal advisors and management. Efforts by professional societies, health educators and organizations to improve end-of-life care can help correct misconceptions and overcome overcaution. These groups can also help promote broader discussion and evaluation of conflict prevention, resolution and management strategies for the care of dying patients. However, the fact that parents have the right to make decisions does not mean that parents and physicians should simply exclude children from discussions and decisions about their care. If children do not receive information and have the opportunity to discuss their fears, concerns and preferences, they may be isolated and their anxiety and other forms of distress amplified. In Chapter 4, the Committee recommended that children and young people be informed and involved in decision-making, based on their circumstances, maturity and preferences, and that they be sensitive to culture and family values. Involving the child and trying to see care through the child`s eyes is also an element of child and family-centred care, as we saw in Chapter 6.

For adolescents in particular, limiting participation in decision-making processes can “lead to unnecessary tension when a therapeutic alliance is needed” (Burns & Truog, 1997, p. 73). Many medical consent forms include a section documenting “consent” to youth care.2 Safety issues inside and outside your facility must be addressed to address potential health or life-threatening concerns.