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Rapid Responses: Rapid Responses published:
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Marginalizing Parents
- Thomas E. Radecki (9 February 2003)
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Gender is omnipresent and parents are not homgeneous
- Tom A Laws (10 February 2003)
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Towards a proper communication
- Eugen Victor Gruber (17 February 2003)
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Thomas E. Radecki, U.S. Clinical Psychiatrist and Lawyer 705 W. Oregon, Urbana, IL 61801
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Dear Sirs: I am very troubled by the philosophy of Bridget Young, et al, in suggesting that parents are often an obstacle to the perceived right of medical professionals to have unimpeded communication with the children of those parents. Young pays passing lip service to not undermining the parent's role, but, make no mistake, she is definitely undermining the rights and responsibilities of parenthood. Obviously, sometimes parents can be overprotective. However, until solid evidence is presented to the contrary, I think that the average parent is much more likely to make a better guardian for his or her child than the average treatment professional. There seems to me to be absolutely no reason why medical professionals shouldn't work with and through parents instead of around parents as suggested by Young. Her unwritten conclusion of finding multiple parents being "obstacles" in her very small sample is much more an indictment of the inadequacy of communications with parents by treatment professionals than it is evidence that a substantial percentage of parents aren't able to make reasonable decisions about their own children. Although we have the same powerful governmental usurpation of parental authority trends in the U.S., I have long noted that Europe is more prone to this philosophy than we are. Perhaps, in some small, but cumulatively important way, such governmental attitudes has something to do with why so many people, especially educated Europeans, are opting to have so few children of their own. England's planned implementation of a "children's national service framework," which has the declared aim of putting children and young people at the centre of care and building services around their needs, is very frightening to me. Clearly, the author sees parents as lacking any right to control communications by outsiders with their own children. Perhaps, sometimes a parent can be educated; perhaps, sometimes a parent knows better than a therapist or their own child. I personally don't think any medical professional has any right to bypass any parent unless there is solid evidence of abuse. I often long for the world my own parents raised me up in where government was far less intrusive. Perhaps, English therapists and physicians have much better interpersonal judgment than that which we find in America. Somehow, this article makes me think otherwise. Thomas E. Radecki, M.D. psychiatrist and lawyer Competing interests: None declared |
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Tom A Laws, lecturer University of South Australia , Adelaide 5000
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Qualitative information concerning the type and amount of information given by parents to young people is an important corner stone in upholding the rights of children and young adults. The paper by Young et al (2002, 326: ) offers an important insight into the rub between parental desires to protect their offspring from unpleasant news whilst at the same time recognising their child’s autonomy. However, the paper falls short in two respects. Although the authors state that they did not address the influence of sex, this factor cannot be simply discounted without explanation. Upholding the argument that qualitative data needs gender analysis is the recognition that there exists women’s health movements / policies and a bourgeoning body of literature pertaining to men’s health based on salient social theories. Ergo, Young et al needed to recognise that the discourse of male children / young adults did not or did, in someway, differ from those of their female counterparts. Secondly, a mythological problem exists in that the voices of the mothers and fathers were aggregated into a single factor, that of “the parent”. This is not an uncommon feature of family research. However, this approach to analysing the data assumes that male and female parents / guardians have the same relationship with their children. This is contrary to literature exploring gender relations within families. Fathers sometimes have a unique relationship with their daughters and the same can be said for mothers and sons. Extrapolated to Young et al’s work this implies that one parent may have a closer understanding of the information needs of their child in times of serious illness. Adding to the call for a disaggregation of data relating to parental discourse is an understanding that mothers tend to be the nexus between their family and health professionals. Therefore women are more likely to be the brokers of health information and the key decision makers as to what information is selectively leaked to family members. Men are more likely to concur with their spouse / partners opinion because they are perceived to be better informed on health and family matters. A verbatim account of inter- parent discussions as to why health information should be withheld would be a valuable prelude to Young et al’s work as it stands. Competing interests: None declared |
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Eugen Victor Gruber, oncopediatrician Oncology Institute, Oncopediatric Department, Sos. Fundeni 252, 72435 Bucharest, Romania
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As a pediatric oncologist I'm very involved in this communication. In my opinion an open communication is a prerequisite for the acceptance of treatment. But all of us involved in this communication (physician, psychologist, nurse, etc.) must take into account the couple of child and parents. Every family has a history of development which depends on the education, conception and behaviour of the parents. Some children are overprotected and are more dependent. They are not prepared for an open communication. But there are many clever children. Children are more mature than they were ten years ago. The explosion of communication, mass media, internet, give today a large possibility for clear and competent information. Every child sooner or later will know the diagnosis. The best communication is with the child and the parents at once, in the presence of the treating team and the psychologist. Another important factor is the quality of the communication. The physician, the nurse and the psychologist must have good communication skills. We must know very well the psychology of the child. We must have enough availability for this dialogue and be honest. There is no unique solution for a proper communication. But when we love children and search not to harm them, we shall find the way to acomplish this difficult duty and win the confidence of the patient and his or her family. Competing interests: None declared |
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