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Defining Medical Neglect in Children

Medical neglect is defined as a parent or guardian’s failure to provide adequate medical care for their child. The term encompasses failure to recognize obvious signs of physical injury, medical illness, or mental health; a delay in seeking medical assistance for an acute illness; ignoring medical recommendations by a physician; and bringing the neglected child to a health care setting only when the child becomes seriously ill or near death.

When it comes to children with chronic illness, the concept includes neglecting medical therapies, not filling medical prescriptions, and not giving the prescribed doses. If a child misses an excessive amount of school due to chronic illness, this also can fall under the category of medical neglect.

Additionally, refusing care for a treatable illness that places the child at risk is considered medical neglect. The most common examples are failure to immunize children for preventable diseases and avoiding treatment with traditional medical care due to religious or cultural belief (though religious exemptions are still allowed in many states).

Diagnosing Medical Neglect

Several factors must be present for a diagnosis of medical neglect, according to the American Academy of Pediatrics:

  1. A child is harmed or at risk of harm because of lack of health care
  2. The recommended health care offers a significant net benefit to the child
  3. The benefit of the treatment is significantly greater than its morbidity, such that a reasonable caregiver would choose treatment over non-treatment
  4. It can be determined that access to health care is available, but is not being used
  5. The caregiver understands the medical advice that is given

Many factors can lead to a child not receiving appropriate medical care, which is why it’s important to carefully consider each situation before diagnosing. Poverty and/or lack of access to care, family disorganization and chaos, lack of awareness, lack of trust in health care professions, impairment or beliefs of the caregiver, and the child’s attitudes can all contribute to neglect. Medical professionals should also be aware of their own blind spots, such as a misunderstanding of other cultures, lack of parent health literacy, or miscommunication in the medical setting, before diagnosing neglect.

Once a determination is made, medical providers can intervene in a number of ways. Keeping in mind that ensuring the child’s health is the primary concern, the Academy has provided health care workers with a list of recommendations for handling medical neglect. In summary, the options range from making sure the family is fully aware of the severity situation to referring the family to hospital programs or child protective service agencies.

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