A case study to identify priorities of care of a Child in relation to legislation and policy

Sample Solution

     

Case Study: Sarah - Balancing Needs with Legislation and Policy

Introduction:

This case study explores the priorities of care for Sarah, a 12-year-old girl, while considering the influence of legislation and policy. Sarah presents with a complex situation that requires balancing her medical needs with her emotional well-being and legal rights.

Scenario:

Sarah has been diagnosed with Type 1 Diabetes Mellitus (T1DM) and requires multiple daily insulin injections. Her parents, John and Mary, are hesitant about allowing Sarah to self-manage her condition due to their anxieties about potential complications. They prefer to maintain complete control over her injections and blood sugar monitoring. However, Sarah desires more independence in managing her diabetes, which aligns with recommendations for age-appropriate self-care.

Full Answer Section

          Considerations for Prioritizing Sarah's Care:

• Medical Needs: Sarah's primary medical needs revolve around effective diabetes management. This includes proper insulin administration, blood sugar monitoring, and dietary control. Legislation such as the Americans with Disabilities Act (ADA) [US Department of Justice, n.d.] ensures access to appropriate medical care and education for children with diabetes.
• Emotional Well-being: Sarah's emotional well-being is crucial. Fear of hypoglycemia (low blood sugar) and parental overprotectiveness can lead to anxiety and depression. The Convention on the Rights of the Child (CRC) [United Nations Office of the High Commissioner for Human Rights, n.d.] emphasizes the right of a child to the highest attainable standard of health, which includes mental health.
• Autonomy and Self-Management: As Sarah matures, fostering her autonomy in managing her diabetes becomes increasingly important. The National Standards for Diabetes Self-Management Education (DSME) [American Association of Diabetes Educators, n.d.] encourages age-appropriate self-care skills for children with diabetes. This aligns with the CRC's principle of children's evolving capacities, recognizing their developing ability to participate in decisions about their health.

Legislation and Policy Framework:

• Child Abuse and Neglect Laws: These laws mandate the protection of children from harm. While parental control over medical care is respected, it cannot come at the expense of Sarah's well-being. Professionals must report suspected neglect if Sarah's diabetes is not adequately managed due to parental anxieties.
• Informed Consent: As Sarah matures, she gains the right to participate in decisions about her care. The Health Insurance Portability and Accountability Act (HIPAA) [US Department of Health and Human Services, n.d.] dictates consent requirements for sharing medical information. Collaboration with Sarah, ensuring she understands treatment options, becomes crucial.
• Education and Support: Legislation like the Individuals with Disabilities Education Act (IDEA) [US Department of Education, n.d.] emphasizes the right to a free and appropriate public education (FAPE) for children with disabilities. Sarah's school needs to be informed and prepared to support her diabetes management needs.

Balancing Priorities - A Collaborative Approach:

• Open Communication: Open communication with Sarah, John, and Mary is paramount. Explain the importance of age-appropriate self-care and provide resources on safe insulin administration and diabetes management.
• Collaborative Care Plan: Develop a collaborative care plan with Sarah's healthcare team, including her doctor, a diabetes educator, and potentially a therapist. The plan should incorporate age-appropriate self-care goals, address parental anxieties, and consider Sarah's emotional needs.
• Graduated Autonomy: Implement a gradual approach to increasing Sarah's autonomy. Start with supervised self-injection and blood sugar monitoring, gradually increasing independence based on her progress and confidence.

Ethical Considerations:

• Confidentiality and Privacy: Maintain confidentiality of Sarah's medical information, adhering to HIPAA guidelines.
• Best Interests Principle: Decisions should always prioritize Sarah's best interests, balancing medical needs, emotional well-being, and age-appropriate autonomy.
• Non-maleficence and Beneficence: Avoid harm and strive to benefit Sarah. This means addressing parental anxieties while ensuring effective diabetes management.

Conclusion: Sarah's case study highlights the intricate balance between a child's medical needs, their emotional well-being, and their evolving autonomy. Legislation and policy frameworks provide a foundation for decision-making, emphasizing aspects like informed consent, child protection, and the right to education. By employing a collaborative approach that integrates Sarah's voice, addresses parental concerns, and empowers her in managing her diabetes, healthcare professionals can strive to achieve the best possible outcomes for Sarah.