Wednesday, October 23, 2019

The World Turned Upside Down

Children are society’s future. We have designed laws to protect children from harm, from fire proof pajamas to when a child is considered mature enough to make life altering decisions. As a Social Worker, my job was to protect children from unsafe home conditions. As a Medical Manger, my job is to protect both doctors and their patients from “never events”. A “never event” in Medicine is an event that, with proper safeguards, will or should never happen.

In Texas a Custodial Court Case over the gender transition of a 7 year old male child is, in my Professional Opinion, a travesty in regards to what is best for the child. The full account of the trial can be read here: “BREAKING: Dallas Jury Grants Mother Sole Custody of Purported Transgender Child”.

The case revolved around divorced parents regarding the medical care of their 7 year old son. The mother, a pediatrician, is maintaining that the child is a female and is desirous of allowing him to transition, up to and including hormones. The father is maintaining that the child is happy being male. The case rested on two questions: "First, did they think that the current joint managing conservatorship should change to a sole managing conservatorship? Second — if they said “yes” to the first question — did they think Younger should be the sole managing conservator?

The jury decided “yes” on the first question and “no” to the second, which results in the mother being the sole manager conservator.

Child rearing is the most difficult task a person can do, even in the best circumstances. Child rearing with an ex-spouse can add another layer of stress, especially if those opinions differ. In this case however, the issue is not whether or not the parents agree, but what is best for the child. An amicus attorney (one appointed by the court to be a neutral observer, recommended:

Contending that both parents loved James, as acknowledged by everyone who interviewed both Younger (father) and Georgulas (mother), he asked the jury to choose for the parents to remain joint managing conservators, and leave the rights and duties of that custody agreement for the judge to rule on in a way that would address the concerns of the father.

The attorney recommended a path that is considered the best plan for a child, whose parents are deemed appropriate to care for that child. In this decision, by allowing the mother full decision making powers, this child’s life could be permanently altered before he is mature enough to understand the consequences.

There are many things we do not let a 7 year old child do, that adults do, because these activities are either dangerous or beyond the comprehension of a child: driving a car, being alone for any length of time, voting, and - obviously -  making medical decisions. It is a parent’s responsibility to keep a child safe and healthy, live in an environment where the child is allowed to grow, and nurture their personalities so that they become a functioning member of society.

As a Social Worker, I can attest that these tasks are not always performed by all parents, but that is why Social Work was created. Helen Northern noted that in the early 20th century in America, there were laws protecting Animals from abuse, but not children. From hers, and many other individuals, laws protecting children were enacted. A major premise of these laws is to protect children from danger, be it from society or from their family situation.

Based on these laws, it is not appropriate to make such a drastic, life altering change to a child when that child is unable to have a decision. Especially, when one parent does not agree.

As a Medical Professional, there are two troubling aspects to this case, both of which revolve around the fact that the parent who wants the transition to be done is a Pediatrician.

In Medicine, it is considered unethical for a doctor to treat a family member. For example, a doctor cannot write a prescription for a family member or be the primary provider of a family member. This is especially important in regards to spouses, parents, and children. The reason is obvious: we as humans are not always objective when it comes to family members, and in the medical profession, it is necessary to be able to objectively make medical decisions. As a Social Worker it appears to be a clear conflict of interest, since the mother is a Pediatrician, between her medical decision making and parental love to give a child what they want. As a Medical Practice Manager, I view this as a doctor overly involved in a medical process with a family member. For the doctor who would perform the treatment, this could become a possible malpractice case by the child, or the objecting parent, over a “never event” being done.

Political correctness should never be a reason to overturn basic parental rights and responsibilities and standard Medical Ethical Guidance.
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