Decision Making in Pediatric Oncology: Who Should Take the Lead? The Decisional Priority in Pediatric Oncology Model

2006 ◽  
Vol 24 (1) ◽  
pp. 160-165 ◽  
Author(s):  
Simon N. Whitney ◽  
Angela M. Ethier ◽  
Ernest Frugé ◽  
Stacey Berg ◽  
Laurence B. McCullough ◽  
...  
Keyword(s):  
Decision Making ◽  
Pediatric Oncology ◽  
Parental Authority ◽  
Ethical Theories ◽  
Clinical Reality ◽  
Parents And Children ◽  
The Family ◽  
Dominant Characteristic ◽  
Medical Choice ◽  
Decisional Authority

Decision making in pediatric oncology can look different to the ethicist and the clinician. Popular ethical theories argue that clinicians should not make decisions for patients, but rather provide information so that patients can make their own decisions. However, this theory does not always reflect clinical reality. We present a new model of decision making that reconciles this apparent discrepancy. We first distinguish decisional priority from decisional authority. The person (parent, child, or clinician) who first identifies a preferred choice exercises decisional priority. In contrast, decisional authority is a nondelegable parental right and duty, in which a mature child may join. This distinction enables us to analyze decisional priority without diminishing parental authority. This model analyzes decisions according to two continuous underlying characteristics. One dominant characteristic is the likelihood of cure. Because cure, when possible, is the ultimate goal, the clinician is in a better position to assume decisional priority when a child probably can be cured. The second characteristic is whether there is more than one reasonable treatment option. The interaction of these two complex continual results in distinctive types of decisional situations. This model explains why clinicians sometimes justifiably assume decisional priority when there is one best medical choice. It also suggests that clinicians should particularly encourage parents (and children, when appropriate) to assume decisional priority when there are two or more clinically reasonable choices. In this circumstance, the family, with its deeper understanding of the child's nature and preferences, is better positioned to take the lead.

scholarly journals Child protection from the civil law perspective – selected issues

2021 ◽  
Vol 11 (1) ◽  
pp. 251-262
Author(s):  
Barbara M. Kałdon
Keyword(s):  
Corporal Punishment ◽  
Child Protection ◽  
Civil Law ◽  
Family Members ◽  
Well Being ◽  
Parental Authority ◽  
Proper Functioning ◽  
Parents And Children ◽  
The Family ◽  
A Minor

Care for the well-being of the youngest family members is one of the main goals of the legislator. A properly functioning family does not require an interference of the officials as long as it does not deviate from the generally accepted standards. However, if such a situation occurs, it is necessary to undertake legal mechanisms aimed at restoring the proper functioning of the family. Consequently, various branches of the law regulate instruments to help the family overcome the crisis. The article presents selected areas of civil law child protection referring to such issues as prohibition of using corporal punishment against a minor and the consequences of its violation, other forms of abusing parental authority, as well as the regulation of certain relations between parents and children.

scholarly journals Ochrona dziecka z perspektywy cywilnoprawnej – wybrane zagadnienia

2021 ◽  
Vol 2021(42) (1) ◽  
pp. 123-134
Author(s):  
Barbara Małgorzata Kałdon ◽  
Keyword(s):  
Corporal Punishment ◽  
Child Protection ◽  
Civil Law ◽  
Family Members ◽  
Parental Authority ◽  
Proper Functioning ◽  
Parents And Children ◽  
The Family ◽  
A Minor ◽  
State Interference

Care for the welfare of the youngest family members is one of the main goals of the legislator. A properly functioning family does not require state interference as long as it does not deviate from the generally accepted standards. However, if such a situation occurs, it is necessary to undertake legal mechanisms aimed at restoring the proper functioning of the family. Consequently, various branches of the law regulate instruments to help the family overcome the crisis which it undergoes. The article presents selected areas of civil law child protection referring to such issues as prohibi- tion of using corporal punishment against a minor and the consequences of its violation, other forms of abusing parental authority, as well as the regulation of certain relations between parents and children.

The role of parents in teenagers' independent decision-making

2020 ◽  
Vol 3 (6) ◽  
pp. 45-47
Author(s):  
Sodiqova Gulbarno Odiljon qizi
Keyword(s):  
Decision Making ◽  
The Family ◽  
Role Of Parents ◽  
Independent Decision

This article provides an overview of the role of parents and parenting methods in teenager independent decision-making in the family, and provides relevant conclusions

Examining perceptions of stress, wellbeing and fear among Hungarian adolescents and their parents under lockdown during the COVID-19 pandemic

2020 ◽  
Author(s):  
Gabor Csikos ◽  
Krisztina Dr Törő ◽  
Judit Mokos ◽  
Sandor Rozsa ◽  
Hadházi Éva ◽  
...  
Keyword(s):  
Family Relationships ◽  
Parental Stress ◽  
Significant Negative Correlation ◽  
Post Traumatic Stress ◽  
Natural Catastrophes ◽  
Parents And Children ◽  
Wellbeing Index ◽  
The Family ◽  
Post Traumatic ◽  
Open Question

Intensified anxiety responses and even symptoms of post-traumatic stress are commonly observed under quarantine conditions. In this study, the effects on fear, anxiety and wellbeing of the recent pandemic caused by SARS-CoV-2 were investigated in a sample of otherwise healthy Hungarians. Taking the family as a microsystem, differences in gender, age, family relationships and time spent in isolation were the main focus of this investigation. 346 parent-child dyads were examined; the children were 11-17 years of age. Standard psychological questionnaires (Perceived Stress Scale, WHO Wellbeing Index), and an open question test (the Metamorphosis test) were used, and the results analysed with the aid of basic statistical methods. Stress levels and wellbeing displayed a significant negative correlation with each other in both parents and children. Parental stress and levels of wellbeing had a weak but significant impact on the wellbeing of their children. Among the demographic variables examined, none of them was found to explain the wellbeing or stress level of parents. Natural catastrophes, such as pandemics, create a stressful social environment for parents, and therefore directly impact the psychological wellbeing of all family members.

Introduction

2018 ◽  
Author(s):  
Bernard Capp
Keyword(s):  
Sibling Relationship ◽  
King Lear ◽  
As You Like It ◽  
Parents And Children ◽  
The Family

This chapter introduces the issues, surveys briefly the existing literature, and sets out the scope of the book. It summarizes contemporary views on the appropriate relationship between siblings, especially the rights and responsibilities of an elder brother towards his sisters and younger brothers. Contemporaries saw these as grounded in both nature and scripture, but recognized too the strength of sibling rivalries and resentments over favouritism and inheritance. These were often explored in contemporary drama, such as Shakespeare’s As You Like It and King Lear, and in social commentaries and polemic. The imagery of brotherhood and sisterhood pervaded the language as well as literature of the period, both as tokens of friendship and (in the case of elder/younger brothers) of oppression within the family. In language as in life, the sibling relationship was a heated and divisive issue for both parents and children.

scholarly journals Enduring Cell Lines: Parents’ Experiences of Postmortem Tumor Banking in Childhood Cancer

2021 ◽  
pp. 107484072110014
Author(s):  
Nancy J. Moules ◽  
Catherine M. Laing ◽  
Wendy Pelletier ◽  
Gregory M. T. Guilcher ◽  
Jennifer A. Chan
Keyword(s):  
Childhood Cancer ◽  
Pediatric Oncology ◽  
Common Factors ◽  
Living Cells ◽  
The Past ◽  
The Family ◽  
Deceased Donors ◽  
Cure Rates ◽  
The Impact ◽  
Parents Experiences

While cure rates in pediatric oncology have improved over the past 30 years, childhood cancer remains the second leading cause of death in children aged 1 to 14. Developing therapies often require using cancerous tissues, which may come from deceased donors. Tumor banks collect, store, and distribute these donated samples. While tumor banking is more common, factors that contribute to parents’ decision and the impact of it on the family are not well understood. The purpose of this hermeneutic study was to understand the meaning and impact of tumor banking for parents of children who have died from cancer. Findings suggest that parents donating their child’s tumors unexpectedly found a sense of meaning in their loss. They also found a legacy of their child’s life; the living cells in some ways assisted the parents with grief. Aspects of this sensitive conversation and decision are discussed from the perspective of the parents’ experiences.

scholarly journals Development and validation of the Family Decision-Making Self-Efficacy Scale

2009 ◽  
Vol 7 (3) ◽  
pp. 315-321 ◽  
Author(s):  
Marie T. Nolan ◽  
Mark T. Hughes ◽  
Joan Kub ◽  
Peter B. Terry ◽  
Alan Astrow ◽  
...  
Keyword(s):  
Decision Making ◽  
Self Efficacy ◽  
Family Members ◽  
Terminally Ill ◽  
Loved One ◽  
The Family ◽  
Family Decision ◽  
Patient Scenario ◽  
Family Decision Making ◽  
Test Retest Reliability

AbstractObjective:Several studies have reported high levels of distress in family members who have made health care decisions for loved ones at the end of life. A method is needed to assess the readiness of family members to take on this important role. Therefore, the purpose of this study was to develop and validate a scale to measure family member confidence in making decisions with (conscious patient scenario) and for (unconscious patient scenario) a terminally ill loved one.Methods:On the basis of a survey of family members of patients with amyotrophic lateral sclerosis (ALS) enriched by in-depth interviews guided by Self-Efficacy Theory, we developed six themes within family decision making self-efficacy. We then created items reflecting these themes that were refined by a panel of end-of-life research experts. With 30 family members of patients in an outpatient ALS and a pancreatic cancer clinic, we tested the tool for internal consistency using Cronbach's alpha and for consistency from one administration to another using the test–retest reliability assessment in a subset of 10 family members. Items with item to total scale score correlations of less than .40 were eliminated.Results:A 26-item scale with two 13-item scenarios resulted, measuring family self-efficacy in decision making for a conscious or unconscious patient with a Cronbach's alphas of .91 and .95, respectively. Test–retest reliability was r = .96, p = .002 in the conscious senario and r = .92, p = .009 in the unconscious scenario.Significance of results:The Family Decision-Making Self-Efficacy Scale is valid, reliable, and easily completed in the clinic setting. It may be used in research and clinical care to assess the confidence of family members in their ability to make decisions with or for a terminally ill loved one.

Decision Making in Child and Family Social Work

2020 ◽  
Author(s):  
Clive Diaz
Keyword(s):  
Decision Making ◽  
Social Workers ◽  
Child Protection ◽  
Protection System ◽  
Senior Managers ◽  
Policy And Practice ◽  
Parents And Children ◽  
Children And Parents ◽  
Selling Point ◽  
New Research

This book presents new research on the extent to which parents and children participate in decision making when childcare social workers are involved and it considers two key meetings in depth: child protection conferences and child in care reviews. There is currently a great deal of interest in how social workers can work more effectively with families and in particular give children a voice. There is also considerable public and media interest in the child protection system, in particular relating to how children are safeguarded by social workers. This book will argue that unless we listen to (and act upon whenever possible) the views of children it is very difficult to safeguard and offer them an effective service. The unique selling point of the book will be that it is based on original solid empirical research following interviews with multiple stakeholders across two local authorities in England including children (n=75), parents (n=52), social workers (n=11, independent reviewing officers (n=8) and senior managers (n=7). This book will consider how 10 years of austerity has impacted on the child protection system and it will have a particular focus on how current practice leads to children and parents often feeling oppressed and excluded in decision making about their lives. The book promises to be authoritative and informed on issues on the ground and very relevant to both policy and practice.

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