Research makes recommendations to avoid parental-clinician disputes going to cou

Dr Sarah Sivers, Associate Dean for Research at Robert Gordon University’s (RGU) School of Law and Social Sciences, and her team spoke to both parents and clinicians within NHS Grampian involved with complex paediatric care.

While there have been many high-profile cases between parents and NHS Trusts arguing their respective cases in court in England, none have yet come to courts in Scotland.

Dr Sivers said: “Despite the lack of court cases in Scotland, there is a considerable population of around 16,700 children with life-shortening conditions where care decisions are required and where parents might disagree with clinicians.

“The lack of any litigated cases in Scotland poses interesting questions as to why disputes in Scotland have not reached the scale of that south of the border, and what can be done to maintain that position as far, or for as long, as possible.

“The lack of any existing evidence base or discussion of this issue in Scotland, means that what we set out is a starting point for work in this area.”

The recommendations made in the study include:

• Strengthening and deepening paediatric clinicians’ skills in communication, relationship‑building, and empathy.
• Establishing an advocacy role that is widely accessible and fully independent from the clinical teams caring for the child.
• Appointing a single, consistent point of contact for parents to help them navigate the complexities of health and social care systems and the diverse support needs of their child.
• Expanding support for parents through the specialist charitable sector, potentially incorporating the advocacy and liaison functions noted above.
• Ensuring earlier and more consistent advance or future care planning.
• Providing reliable institutional support for clinicians from management, alongside improved access to and awareness of clinical ethics committees as forums for discussing complex care decisions.

Dr Sivers and the research team feel further research in this specific field is required with a focus on how Scottish legal principles and clinical practice would handle such a disagreement if it came to court.

Further research needs to be done Scotland-wide to develop accessible resources and support for both parents and clinicians dealing with intensely difficult situations and Dr. Sivers is working on this with key stakeholders including Children’s Hospices Across Scotland, NHS Lothian and the Medical Mediation Foundation.

Dr Sivers worked on this research project with Dr Heather Morgan from University of Aberdeen, Prof Steve Turner and Dr Fiona Herd from NHS Grampian, and legal academic Margaret Downie. It was also supported by NHS Grampian Charity. 

Read the full paper:
Taylor & Francis - Disagreements about paediatric treatment