Or. Admin. Code § 413-020-0600 - Purpose
(1) The purpose of
these rules is to comply with Public Law 98-457, which requires that procedures
be established within Oregon's Child Protective Services (hereafter referred to
as CPS) program to respond to reports of suspected medical neglect, including
reports of withholding medically indicated treatment for disabled infants with
life-threatening conditions. The regulations indicate that the focus of the
Department CPS work will be, "as it is in responding to other reports of child
abuse and neglect, to protect the child and assist the family." Hospitals are
encouraged to form review committees to assist with medical and ethical
dilemmas arising in the care of disabled infants with life-threatening
conditions. Due to the sensitive nature of these cases and the specialized
skills required to complete the investigations, the Department will designate a
Child Welfare staff person in each of the three cities having tertiary care
centers (Portland, Eugene, and Medford) to be a specialist in Medical Neglect
investigations. These Medical Neglect Investigators, along with the CPS program
manager, will be available to provide telephone consultation and investigations
of reports alleging medical neglect of handicapped infants with
life-threatening conditions. The Medical Neglect Investigators will form a
special investigation "team" with a Designated Consultant Neonatologist and a
local CPS caseworker.
(2) The
federal regulations emphasize that parents are the decision makers concerning
treatment for their disabled infant based on advice and reasonable medical
judgment of their physician(s) with advice from the Hospital Review Committee,
if one exists. It is not the Department nor the HRC, nor any other committee,
who makes decisions regarding the care and treatment for a child except in
highly unusual circumstances where the course treatment is inconsistent with
applicable standards established by law.
(3) The legislation requires that appropriate
nutrition, hydration, and medication shall always be provided to the infant,
and that the effectiveness of treatment shall not be based on subjective
opinions about the future "quality of life" of an infant. In response to a
report of medical neglect of a disabled infant with a life-threatening
condition, Department's investigative role is to determine if the decision made
to withhold treatment was based on reasonable medical judgment consistent with
the definition of "withholding of medically indicated treatment." (see
Definition section)
Notes
Stat. Auth.: HB 2004
Stats. Implemented: PL 98-457
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