爱心包裹扶贫捐赠最新累计统计.ppt

Judicial Intervention For Morbidly Obese Children:An Interesting Case Interesting Case Presentation Saint Francis Hospital Dept. of Pediatrics Jay E. Sicklick, Esq. Lisa Kechejian MEDICAL-LEGAL PARTNERSHIP PROJECT October 26, 2007 Presentation Goals Introduce the “obesity dilemma” Provide a case example of childhood obesity – in the child protection context Overlay the legal background Query - when do you request “state intervention?” Invite discussion re “what is the appropriate intervention protocol?” The Problem The Threshold Question When does obesity become a child protection issue for the clinician? OR … How out of control do things have to get before you call DCF when dealing with a morbidly obese child? Case Study Brittany T: Age 8 – morbidly obese 237 lbs BMI 50 Co-morbidities: gallstone, excessive fat in liver, sleep apnea, acanthosis nigricans, signs of depression Father confined to wheelchair/mother 430 lbs. in April ’06 Case Study (cont.) Brittany: PCP indicates significant non-compliance with dietary instructions “Threats” made on several occasions to call child welfare officials? Parents seem “incapable” of controlling Brittany’s weight, but really love her Brittany will be emotionally devastated if removed from home… Case Study (cont.) What is the appropriate decision? Who decides when enough is enough? Do you think that removal and commitment is appropriate Is termination of parental rights a justified action? Legal Context Mandated Reporting Requirements Reasonable Cause to Suspect: Abuse Neglect Child w/non-accidental physical injury or one at variance w/history given Child At Imminent Risk of Harm Legal Background Abuse: Inflicted w/physical injuries other than by accidental means, Injuries at variance w/history given Condition result of Maltreatment such as malnutrition, sexual molestation/exploitation, deprivation of necessities, emotional maltreatment or cruel punishment Legal Background (cont.) Neglect: Abandonment Denia