GetMeOuttaThisMess Posted September 9, 2016 Share Posted September 9, 2016 Pediatric patient with non-emergent illness trying to be scheduled by non-legal guardian family member (no paperwork), this unable to obtain LEGAL consent to treat. Only living parent is unaccounted for. Would you see pt.? Link to comment Share on other sites More sharing options...
Febrifuge Posted September 9, 2016 Share Posted September 9, 2016 Nope. Link to comment Share on other sites More sharing options...
Reality Check 2 Posted September 9, 2016 Share Posted September 9, 2016 I have been in this situation and it is very tough. However, these folks taking care of kids need to follow some legal procedure to gain legal custody and guardianship so everyone involved is kosher and treatment is legal. In an emergency - choking, deadly asthma - I don't care who walks in with the kid - I will take action. Otherwise, these folks need to get their ducks in a row and protect this kid. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted September 9, 2016 Author Share Posted September 9, 2016 I agree, and would see in an emergency situation (you do this not infrequently in EDs). Looks like we're going to accept if adult shows 1040 with evidence of claiming of child as a dependant. Link to comment Share on other sites More sharing options...
Reality Check 2 Posted September 9, 2016 Share Posted September 9, 2016 Very tough situation. We have lots of grandparents raising grandkids because parents are incarcerated or just AWOL. No papers, no court orders, nothing. One family brought me a baby - very odd living situation with 12 folks living in a mobile home. Banjos and pot smoke galore. I asked who the baby belonged to and the 4 adults looked at each other like I had a horn. I said "who gave birth to this baby" and they finally told me it belonged to a "friend" who was having a hard time and dropped her off before disappearing. Well, that was a messed up situation - in so many ways. We had foster kids removed from one home and placed with fosters in the same neighborhood or small town. Made for uncomfortable encounters. I had to find out who was legally allowed in the room and if there were no contact orders (quite frequently) and who had say over immunizations. What a mess and the one who needs care can't speak for themselves a lot of times. Some of the kids I just wanted to take home...... The courts could help us out in some of these situations by producing a document stating who has custody and who can't be around the kid. Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted September 9, 2016 Moderator Share Posted September 9, 2016 In an emergent situation I don't think anyone here would not treat. I agree that in most instances I would not. Many nuances here that would make me consider it, but not as a general rule. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted September 9, 2016 Administrator Share Posted September 9, 2016 I agree, and would see in an emergency situation (you do this not infrequently in EDs). Looks like we're going to accept if adult shows 1040 with evidence of claiming of child as a dependant. That's what a clinic administrator is for: accepting or rejecting non-medical legal risk. Make them earn their money and document their decision! Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted September 9, 2016 Author Share Posted September 9, 2016 We do and they did. Link to comment Share on other sites More sharing options...
LKPAC Posted September 9, 2016 Share Posted September 9, 2016 Here's the problem: define a non-emergency situation in which you would not treat. Today, the child has a low-grade repiratory illness and you refuse to see him. In a few days, the child has pneumonia and dies. I would much prefer to defend my actions for treating a child, then I would for not treating. Link to comment Share on other sites More sharing options...
Reality Check 2 Posted September 10, 2016 Share Posted September 10, 2016 Here's the problem: define a non-emergency situation in which you would not treat. Today, the child has a low-grade repiratory illness and you refuse to see him. In a few days, the child has pneumonia and dies. I would much prefer to defend my actions for treating a child, then I would for not treating. I have always advocated for kids and gone above and beyond when needed because they can't care for themselves or make decisions and need to be watched out for. Basically - whatever it takes - do right by the kiddo. You won't ever regret it, in my mind. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted September 10, 2016 Author Share Posted September 10, 2016 I have no idea how old the individual in question is. Link to comment Share on other sites More sharing options...
TWR Posted September 12, 2016 Share Posted September 12, 2016 The talk on this topic leaves a bad taste. Is everyone worried about covering their own A**. What about the child? The comment about low fever today and pneumonia and dead in 3 days (as an example) rings loud and clear in my head. Also I don't think getting custody is as simple as filling out a one page application and takes months to do. I will treat the child and take the heat. I want to sleep at night. Link to comment Share on other sites More sharing options...
Katera Posted September 12, 2016 Share Posted September 12, 2016 Emergency = Yes Anything else...= No way When the mom shows up and sues you for treating the kid without authorization, good luck. What does your state law say? Texas is actually pretty specific. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted September 12, 2016 Author Share Posted September 12, 2016 The talk on this topic leaves a bad taste. Is everyone worried about covering their own A**. What about the child? The comment about low fever today and pneumonia and dead in 3 days (as an example) rings loud and clear in my head. Also I don't think getting custody is as simple as filling out a one page application and takes months to do. I will treat the child and take the heat. I want to sleep at night. This is not an emergency, you are not functioning as the pt.'s PCP, and other treatment options are available since this pt. IS insured. This is a facility of "convenience" to the eligible parties. Regardless of the "filling out of papers", you still legally have to have consent to treat unless it is an emergency. FWIW, I have seen pt.'s in f/u who return though it is against clinic policy for the reason you mention. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted September 12, 2016 Author Share Posted September 12, 2016 Emergency = Yes Anything else...= No way When the mom shows up and sues you for treating the kid without authorization, good luck. What does your state law say? Texas is actually pretty specific. Mom will only appear in person if she rises from the dead, per defacto guardian. Dad is the one allegedly MIA. Link to comment Share on other sites More sharing options...
Reality Check 2 Posted September 12, 2016 Share Posted September 12, 2016 Unfortunately, litigation is a major factor in cases like this. Doing right by a child doesn't seem to hold any weight. It's all about the authorizations and consent. So, kids get treated like poo by adults who can't even be adult much less parents. BUT, we are the ones who will get our licenses slapped or worse or get sued for actually taking care of a kid. It sucks but there have to be boundaries and limits. Getting custody or guardianship is not easy and there are no instruction manuals and even fewer social workers to help guide folks. It is another part of our glorious system that needs some overall, tort reform, better parenting and a society that values kids more. Link to comment Share on other sites More sharing options...
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