Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-25T17:21:59.151Z Has data issue: false hasContentIssue false
  • English
  • Français

When a foreign adolescent orphan refuses to be treated: Considerations on a clinical case

Published online by Cambridge University Press:  24 March 2015

Carlo Alfredo Clerici ,
Giovanna Casiraghi ,
Laura Veneroni ,
Emilia Pecori ,
Tullio Proserpio ,
Lorenza Gandola  and
Maura Massimino
Carlo Alfredo Clerici*
Affiliation:
Dipartimento di Fisiopatologia Medico–Chirurgica e dei Trapianti, Università degli Studi di Milano, Italy SSD Psicologia, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milano, Italy
Giovanna Casiraghi
Affiliation:
SC Pediatria, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milano, Italy
Laura Veneroni
Affiliation:
SC Pediatria, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milano, Italy
Emilia Pecori
Affiliation:
SC Radioterapia Oncologica 1, SS Radioterapia Pediatrica, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milano, Italy
Tullio Proserpio
Affiliation:
Cappellania Ospedaliera, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milano, Italy
Lorenza Gandola
Affiliation:
SC Radioterapia Oncologica 1, SS Radioterapia Pediatrica, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milano, Italy
Maura Massimino
Affiliation:
SC Pediatria, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milano, Italy
*
Address correspondence and reprint requests to: Carlo Alfredo Clerici, SSD Psicologia, Fondazione IRCCS, Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133 Milano, Italy. E-Mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Providing medical treatment for unaccompanied foreign minors can prove particularly demanding when a patient is not fully compliant. This report describes the case of a 13-year-old boy from Sub-Saharan Africa brought to Italy to receive treatment for a neoplasm. Right from the start, he showed strong oppositional reactions, with aggressive and self-harming behavior. This made it necessary to activate various different psychological, psychiatric, and social-support resources, and to adapt the proposed treatments to the patient's willingness and ability to cooperate. Here we outline the assessments and actions (also from the economic and organizational standpoint) that need to be implemented in any scheme to bring young foreign orphans to Italy for specialist medical care.

Keywords

AdolescentsOncologySelf-harmNoncompliance
Type
Case Reports
Information
Palliative & Supportive Care , Volume 13 , Issue 6 , December 2015 , pp. 1791 - 1795
Copyright
Copyright © Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

American Psychiatric Association (APA) (1999). Diagnostic and statistical manual of mental disorders, 4th ed., Text revision (DSM–IV–TR), Washington, DC: American Psychiatric Publishing.Google Scholar
American Psychiatric Association (APA) (2013). Diagnostic and statistical manual of mental disorders, 5th ed. (DSM–V). Washington, DC: American Psychiatric Publishing.Google Scholar
Appelbaum, P.S. (2007). Clinical practice: Assessment of patients' competence to consent to treatment. The New England Journal of Medicine, 357, 1834–1840.Google Scholar
Foucault, M. (1974). Maladie mentale et psychologie. Paris: Presses Universitaires de France.Google Scholar
Geist, R. & Opler, S.E. (2010). A guide for health care practitioners in the assessment of young people's capacity to consent to treatment. Clinical Pediatrics (Philadelphia), 49, 834–839.Google Scholar
Harrison, C., Kenny, N.P., Sidarous, M., et al. (1997). Bioethics for clinicians, 9: Involving children in medical decisions. CMAJ, 156, 825–828.Google Scholar
Joffe, S., Truog, R.D., Shurin, S.B., et al. (2006). Ethical considerations in pediatric oncology. In Principles and practice of pediatric oncology, Pizzo, P.A. & Poplack, D.G. (eds.), pp. 1466–1489. Philadelphia: Lippincott Williams & Wilkins.Google Scholar
Larcher, V. & Hutchinson, A. (2010). How should paediatricians assess Gillick competence? Archives of Disease in Childhood, 95, 307–311.Google Scholar
McCabe, M.A. (1996). Involving children and adolescents in medical decision-making: Developmental and clinical considerations. Journal of Pediatric Psychology, 21, 505–516.Google Scholar
Shaw, M. (2001). Competence and consent to treatment in children and adolescents. Advances in Psychiatric Treatment, 7, 150–159.Google Scholar
Weithorn, L.A. & Campbell, S.B. (1982). The competency of children and adolescents to make informed treatment decisions. Child Development, 53, 1589–1599.Google Scholar