Is delaying medical care for a child's diabetes mellitus (DM) and liver disease considered child abuse?

From the Guidelines

A parent delaying necessary medical care for a child with diabetes and liver disease is considered child abuse, specifically medical neglect. When a child has serious conditions like diabetes and liver disease that require timely medical intervention, parents have a legal and ethical responsibility to seek appropriate treatment [ 1, 1 ]. These conditions can rapidly deteriorate without proper management, potentially causing permanent organ damage, diabetic ketoacidosis, liver failure, or even death.

Key Considerations

• The standard of care for diabetes management includes regular monitoring of blood glucose levels, insulin administration, and dietary changes 1.
• For children and adolescents with type 1 diabetes, an interprofessional team trained in pediatric diabetes management should provide diabetes-specific care, including diabetes self-management education and support, medical nutrition therapy, and psychosocial/behavioral support 1.
• Delaying or refusing necessary care can lead to significant harm, including permanent organ damage, diabetic ketoacidosis, liver failure, or even death.

Legal and Ethical Responsibilities

• Most jurisdictions have laws that classify failure to provide necessary medical care as neglect or abuse.
• Healthcare providers are mandated reporters who must notify child protective services when they suspect medical neglect.
• Parents may have concerns about treatments or seek second opinions, but completely delaying or refusing necessary care crosses the line into neglect when it places the child at significant risk of harm.

Recommendations

• Parents should follow medical advice for managing diabetes and liver disease, including administering insulin for diabetes and any prescribed medications for liver disease.
• Healthcare providers should provide guidance on the standard of care for these conditions and monitor the child's condition regularly to prevent complications.
• If a parent is delaying or refusing necessary care, healthcare providers should take immediate action to report suspected medical neglect and ensure the child receives timely and appropriate treatment.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Definition of Child Abuse

• Child abuse is a complex issue that can take many forms, including physical, emotional, and neglect [(2,3)].
• Medical neglect is a specific type of child abuse that occurs when a caregiver fails to provide a child with necessary medical care [(2,3)].

Delaying Care for Diabetes and Liver Disease

• Delaying care for diabetes and liver disease in a child can be considered a form of medical neglect [(2,3)].
• The decision to delay care can be influenced by various factors, including cultural, religious, financial, or philosophical differences between the healthcare providers and families 3.

Importance of Providing Medical Care

• Providing necessary medical care is crucial for the well-being and health of a child [(2,3)].
• Good medical care can help prevent medical neglect and ensure that children receive the care they need to achieve their full potential 2.

Liver Disease and Diabetes

• There is a significant association between liver disease and diabetes, with diabetes increasing the risk of liver disease and vice versa [(4,5)].
• Managing diabetes in patients with liver disease requires careful consideration of the patient's overall health and may involve lifestyle modifications and careful selection of medications [(4,6)].