Edited 17/02/2021
Decision making for medical treatment prior to the Adoption Order
Ruby123
May 27, 2016 21:59
Hi Our child has a condition that prior to placement we were told would require a number of operations to address and we were advised that a social worker would have to come to the hospital with us to sign the consent form. However, the condition isnât responding as well as previously hoped and after the last operation the consultant raised the possibility of considering a more aggressive treatment that comes with potentially serious side effects. We havenât got the Adoption Order yet and so I contacted the SW to ask how the decision making process would work but they havenât come across this before and so I thought I would ask here as I may be waiting some time for them to get back to me with an answer. Also the SW mentioned about delaying the AO application so they can assess potential support needs. However, we donât feel that this is in our childâs best interests as the consultant was vague about timescales and in one instance talked about considering the next step in 6 months and another conversation mentioned waiting another year or so. Without going into details which may be identifying, it is doubtful that there could be any particularly useful support the LA could provide should the side effects happen, it is just something that we would have to accept and deal with. I wanted to hear from other parents how much they were involved in the decisions about any change in the treatment plan prior to having parental responsibility. Did the Local Authorityâs medical advisor simply make the decision or were you involved and consulted in a meaningful way? I understand that this is a sensitive subject and potentially identifying so please PM me if you prefer.
Midge
May 28, 2016 00:03
The LA may discuss with the medical advisor but in my experience the SW and someone at service manager level will want to be party to discussions, in all honestly the consultant should be writing including them in his/her correspondence and inviting all parties to a meeting to discuss the way forward. My son was my LAC when he needed treatment for cancer, his consultant considered us all; SS, BPs and us, his FC to be partners in discussions. Different for you as BPs are not in the frame, but as his prospective parents you need to be fully engaged and consulted in decisions which ultimately are likely to be made on basis of researched outcomes and evidence base. The LA will be led by what is evidenced to be the best treatment leading to best outcomes. This isn't as rare as you may think. I'm a paeds nurse and come across this type of scenario with LAC fairly often, even LTFC are very involved in treatment plans of their looked after children. But this should be coming from the consultant, ours was incredibly pro-active and wanted full and frank exposure and discussions with all parties.
Edited 17/02/2021
MissPicklepot
May 28, 2016 01:50
My LO was under a number of consultants and we had been told she would require open heart surgery at some stage in near future. While still LAC we attended appointments and SW just asked for feedback about various appointments when we had out lac meetings per AO. Consultants never made contact with SW or the dept once placed (did pre placement) but it was different area and hospital. Regards making decisions on treatment I was told that if surgery was required it would be taken on the recommendation of the medical professional (and if appropriate second medical prof if required). So basically if consular at said it was in LO best interest to act now then they would. In our case consultant wanted to wait a little to see if any improvement. I agreed and that was that. Social services didn't get involved or comment on it when I feed back. LO was post AO next appointment so no longer an issue. But I found my LO's SW really layed back and I provided a report on all appointments at meetings. I think in reality SW will have to go with what medical professionals recommend. They are not the professionals in this area so I imagin if they made any other decision against medical advice then they could become liable if anything happened to child and they had acted against medical advice. When they say assess support needs are they thinking adoption allowance or financial support? Then it maybe worth waiting but you can still access post adoption support from the LA 3 years post order. Good luck and hope everything turns out ok.
Edited 17/02/2021
MissPicklepot
May 28, 2016 01:50
My LO was under a number of consultants and we had been told she would require open heart surgery at some stage in near future. While still LAC we attended appointments and SW just asked for feedback about various appointments when we had out lac meetings per AO. Consultants never made contact with SW or the dept once placed (did pre placement) but it was different area and hospital. Regards making decisions on treatment I was told that if surgery was required it would be taken on the recommendation of the medical professional (and if appropriate second medical prof if required). So basically if consular at said it was in LO best interest to act now then they would. In our case consultant wanted to wait a little to see if any improvement. I agreed and that was that. Social services didn't get involved or comment on it when I feed back. LO was post AO next appointment so no longer an issue. But I found my LO's SW really layed back and I provided a report on all appointments at meetings. I think in reality SW will have to go with what medical professionals recommend. They are not the professionals in this area so I imagin if they made any other decision against medical advice then they could become liable if anything happened to child and they had acted against medical advice. When they say assess support needs are they thinking adoption allowance or financial support? Then it maybe worth waiting but you can still access post adoption support from the LA 3 years post order. Good luck and hope everything turns out ok.
Edited 17/02/2021
Ruby123
May 28, 2016 20:18
Thank you so much for your replies and sharing your experiences, it has been really helpful. The LA must have done this lots of times before but our child's SW has not and so she couldn't talk me through how it would work compared to what has been happening up until now. Her case load is horrendous so I'm unsure when she will get back to me and wanted some reassurance and more information in the meantime. Currently a SW attends on the morning that he goes in for the operation to sign the consent form but they aren't present for the post Op debrief (which is when the consultant raised the possibility of having to change the treatment plan) so I simply report back after discharge. His condition isn't one where there is a very clear cut sign that they definately need to change course treatment wise. It is more likely to be a gradual deterioration and there could be a difficult grey area when the medics are trying to weigh up the benefits versus the risks of the more aggressive surgery which is why I was keen to hear how involved we may be in the decision. What you have outlined above reassures me that we will have the opportunity to have input into the descision (although obviously we will be guided by the consultants). Regarding support needs I would find it difficult to believe that we would be eligible for the adoption allowance if our little one was unlucky enough to have the specific complications that the consultant outlined. Therefore, I think it is in our childs interests for us to proceed with the AO as soon as possible. Thanks again
Edited 17/02/2021
Special kids mummy
May 28, 2016 20:31
Both of our LO's have complex medical and physical needs, the day they were placed with us we had written permission from their placing LA's to sign any consent forms and make medical decisions if needed. We would then report back to SW's when we could. They recognised that looking after children like ours things changed quickly and decisions needed to be made and we going to be their legal parents. I think go for the AO as soon as you can it will make your life much easier! Hope everything goes well for your LO x
Edited 17/02/2021
Archived
This topic is archived. New posts are not allowed.
