Offering sanctuary to those fleeing war is a pressing human rights issues in the world today. Globally, there are currently 25.4 million people forced to leave their home to seek safety. Half of these people are children. Despite these staggering statistics, governments seem to have ignored their duty of care to children.
This article highlights the importance of psychological and medical evaluations for asylum seekers in the United States, and identifies physicians and other healthcare professionals as uniquely situated for this work. This paper outlines the benefits and drawbacks to such evaluations and addresses their utility in immigration law, ultimately calling for increased clinician involvement in pro bono evaluations.
In recent years, the unique role of medical professionals in the asylum adjudication process has been thrown into sharp relief as asylum applications surge, with over one million pending cases backlogged in the U.S. asylum system as of August 2019. Medical evaluations dramatically increase the likelihood of an individual obtaining asylum. The author examines the role medical trainees play in this process.
How did we get here? Mara, now nearly 17-years-old, was born with a neurogenic bladder. Up until two years ago, she was a model patient. No one worried about her adherence with self-catheterization or medications. She was optimistic about her future, cared about her health, and we looked forward to her bright and open future. But now Mara says,
“I don’t care.”
“Suffering” is a concept that is frequently invoked in discussions about medical decision-making in pediatrics. However, empirical accounts of how the term is used are lacking, creating confusion about the concept and leaving parents and providers unsure about the appropriate ways to account for it in pediatric decision-making. We conducted a qualitative content analysis of pediatric bioethics and clinical literature in selected journals from 2007 to 2017 to determine how authors define and operationalize the term when referring to issues in pediatric treatment.
Use of sedation and restraints is sometimes the only means available to stabilize medically fragile eating disorders patients. While minors are not given the option to refuse care that competent adults are, forced tube feeding nonetheless challenges the minor patient’s senses of identity and control. The following case study chronicles the management of an 11-year-old patient transferred from inpatient child psychiatry unit to the adolescent medicine service for nutritional rehabilitation.
Information technology in the 21st century has resulted in physicians coming to rely on data. However, when clinicians are conditioned to rely on data and suppress clinical judgment, it becomes difficult to manage rare conditions where data is not available. The following discussion recounts one family’s experience with clinical counseling on a rare diagnosis and highlights these issues.