A hospital risk manager has been called to the Neonatal Intensive Care Unit to discuss...

According to Health Care Risk Management standards supported by ASHRM and the American Hospital Association Certification Center, while parents generally serve as surrogate decision-makers for minors, their authority is not absolute. When refusal of treatment places a child at significant risk of serious harm or death, healthcare providers have an ethical and legal obligation to act in the best interests of the child.

In cases involving life-sustaining treatment for a premature infant, refusal of a medically necessary blood transfusion may constitute potential medical neglect if it threatens the infant’s survival. When disagreement persists after appropriate communication and ethics consultation, and the infant’s life is at risk, the appropriate step is to seek judicial intervention. Contacting legal counsel to obtain an emergency court order allows the state to exercise its parens patriae authority to protect the child’s welfare.

An ethics consultation may help clarify values and promote dialogue but does not override urgent medical necessity. Simply prohibiting or proceeding without legal authority exposes the organization to liability.

Legal and regulatory objectives emphasize protecting vulnerable patients while respecting due process. Therefore, seeking an emergency court order through legal counsel is the appropriate action.