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Grand Rounds: Parental Refusal of Pediatric Cancer Therapy: An Ethical Dilemma


By Eric Kodish, MD , Professor of Pediatrics, Cleveland Clinic, Lerner College of Medicine

Objectives (Educational Content) :

1. Recognize how a framework of pediatric ethics can provide a foundation for analysis of the parental treatment refusal dilemma. 2. Determine whether reasons matter when it comes to decisions related to physician responsibility in these cases. 3. Be aware of the complexity and decide which variables are most important when trying to “do the right thing” in challenging circumstances.

Target Audience:

General pediatricians, family physicians, nurse practitioners, physician assistants, social workers, psychologists and nurses.

Identified Gap:

Physicians are occasionally faced with difficult decisions in dealing with parent refusal of cancer therapy. Increased awareness of the complex issues within the structure of pediatric ethics can provide the physician enhanced insight into this dilemma.

Estimated Time to Complete the Educational Activity:

1 hour

Expiration Date for CME Credit:


Method of Physician Participation in the Learning Process:

The learner will view the presentation, successfully complete a post-test and complete an activity evaluation.

Evaluation Methods:

All learners must successfully complete a post-test, as well as an activity evaluation, to claim CME credit.

Accreditation Statement:

Children’s Hospital Medical Center of Akron is accredited by the Ohio State Medical Association to provide continuing medical education for physicians.

CHMCA designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1 Credit ™. Physicians should only claim the credit commensurate with the extent of their participation in the activity.


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Informed Consent, Parental Permission, and Assent in Pediatric Practice, Bioethics Comm. of the AAP, Pediatrics 95:2, 1995