Ask Dr. Holmes: Avoiding “Medical Neglect” When You Disagree With Psychiatrist

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Question
What can a foster parent do when the psychiatric doctor wants to prescribe a prescription that neither the young adult (15) or foster parent believes is in the best interest of the child; but the agency says the child will be removed for “medical neglect” if the foster parent doesn’t support the administering of the drug?

Answer
This is a very good question. The key idea in a situation like this has to do with the importance of communication. It is not unusual for the various adults involved in this type of case to have disagreements concerning treatment. In addition, children and teenagers often have questions and concerns, which may lead to their own questions about treatment.

In such cases there is no substitute for communication. If a 15 year old does not want to take medication, or does not believe he/she needs medications, this requires serious consideration. Ultimately, it is not a good idea for adolescents to feel like they are being pressured into doing something they don’t think is in their best interest. Such concerns require a thoughtful discussion among the adolescent, interested adults, and the provider.

Likewise, if there are differences of opinion between foster parents and the placing agency, an open and honest discussion needs to occur before the issue of “medical neglect” is raised. The charge of neglect is serious and should be reserved for situations in which there is clear evidence of a refusal or inability to comply with treatment, despite clear evidence that treatment would be helpful. In almost all cases, these issues should be able to be resolved through discussion.

So, it all comes back to open communication and making sure that all sides are heard. This is not always easy, and it requires more time and effort. However, this approach will usually prevent conflicts that could arise.

Dr. William Holmes is the Senior Medical Director for Cenpatico Behavioral Health, and specializes in foster care medical issues.  If you have a question for Dr. Holmes, please send it to askdrholmes@nfpaonline.org

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