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dc.contributor.authorNair, T
dc.contributor.authorSavulescu, J
dc.contributor.authorEverett, J
dc.contributor.authorTonkens, R
dc.contributor.authorWilkinson, D
dc.date.accessioned2020-12-18T02:37:47Z
dc.date.available2020-12-18T02:37:47Z
dc.date.issued2017-12-01
dc.identifierpii: medethics-2016-103461
dc.identifier.citationNair, T., Savulescu, J., Everett, J., Tonkens, R. & Wilkinson, D. (2017). Settling for second best: when should doctors agree to parental demands for suboptimal medical treatment?. JOURNAL OF MEDICAL ETHICS, 43 (12), pp.831-840. https://doi.org/10.1136/medethics-2016-103461.
dc.identifier.issn0306-6800
dc.identifier.urihttp://hdl.handle.net/11343/255428
dc.description.abstractBACKGROUND: Doctors sometimes encounter parents who object to prescribed treatment for their children, and request suboptimal substitutes be administered instead (suboptimal being defined as less effective and/or more expensive). Previous studies have focused on parental refusal of treatment and when this should be permitted, but the ethics of requests for suboptimal treatment has not been explored. METHODS: The paper consists of two parts: an empirical analysis and an ethical analysis. We performed an online survey with a sample of the general public to assess respondents' thresholds for acceptable harm and expense resulting from parental choice, and the role that religion played in their judgement. We also identified and applied existing ethical frameworks to the case described in the survey to compare theoretical and empirical results. RESULTS: Two hundred and forty-two Mechanical Turk workers took our survey and there were 178 valid responses (73.6%). Respondents' agreement to provide treatment decreased as the risk or cost of the requested substitute increased (p<0.001). More than 50% of participants were prepared to provide treatment that would involve a small absolute increased risk of death for the child (<5%) and a cost increase of US$<500, respectively. Religiously motivated requests were significantly more likely to be allowed (p<0.001). Existing ethical frameworks largely yielded ambiguous results for the case. There were clear inconsistencies between the theoretical and empirical results. CONCLUSION: Drawing on both survey results and ethical analysis, we propose a potential model and thresholds for deciding about the permissibility of suboptimal treatment requests.
dc.languageEnglish
dc.publisherBMJ PUBLISHING GROUP
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.titleSettling for second best: when should doctors agree to parental demands for suboptimal medical treatment?
dc.typeJournal Article
dc.identifier.doi10.1136/medethics-2016-103461
melbourne.affiliation.departmentMelbourne Medical School
melbourne.source.titleJournal of Medical Ethics
melbourne.source.volume43
melbourne.source.issue12
melbourne.source.pages831-840
dc.rights.licenseCC BY
melbourne.elementsid1283986
melbourne.contributor.authorSavulescu, Julian
dc.identifier.eissn1473-4257
melbourne.accessrightsOpen Access


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