I. Definition

The withholding of appropriate nutrition, hydration, medication, or other medically indicated treatment from a disabled infant with a life-threatening condition. Medically indicated treatment includes medical care which is most likely to relieve or correct all lifethreatening conditions and evaluations or consultations necessary to assure thatsufficient information has been gathered to make informed medical decisions. Nutrition, hydration, and medication, as appropriate for the infant's needs, is medicallv indicated for all disabled infants. Other types of treatment are not medically indicated when:

• The infant is chronically and irreversibly comatose,

• The provision of the treatment would be futile and would merely prolong dying, or

• The provision of the treatment would be virtually futile and the treatment itself would be inhumane under the circumstances.

In determining whether treatment will be medically indicated, reasonable medical judgments, such as those made by a prudent physician knowledgeable about the case and its treatment possibilities, will be respected. However, opinions about the infant's future "quality of life" are not to bear on whether a treatment is judged to be medically indicated.

NOTE:Review FSPP Policy and Procedure Section lI-F, Medical Neglect A Disabled Infant.

II.Taking a report

A.   An acceptable reporter is any person with reasonable cause to suspect that a disabled infant with a life-threatening condition has been/is being medically neglected.

B.   Usage

The reporter has reason to believe that the disabled infant has not received/is not receiving medically indicated treatment (including appropriate nutrition, hydration, medication, and independent evaluations and consultations) due to the parent's or caretaker's disregard of his or her responsibilities.

C.   Factors to be considered

• Infant's physical condition,

• Seriousness of the current health problem,

• Probable medical outcome if the current health problem is not treated and the seriousness of that outcome,

• Generally accepted medical benefits of the prescribed treatment,

• Generally recognized side effects/harms associated with the prescribed treatment,

• The opinions of the Infant Care Review Committee (ICRC), if the hospital has an ICRC,

• The judgment of the individual designated by contract for the purposes of coordination, consultation, and notification of cases of suspected medical neglect of disabled infants (Refer to FSPP lI-F), and

• The parent's knowledge and understanding of the treatment and the probable medical outcome.

III. Founding a report

This allegation of maltreatment may be founded only after the Family Service Worker has done the following:

• Verified that medical treatment (including appropriate nutrition, hydration, or medication) is/was withheld from an infant; and

• Secured credible evidence that the infant is/has been medically neglected due to the parent's or caretaker's disregard of his or her responsibilities; and

• Applied the factors in Section II, C, above and determined that the treatment was medically indicated. Such verification must come from a physician and may come from experts in the field of neonatal pediatrics. Appropriate nutrition, hydration, and medication is medically indicated for all disabled infants.