Aim: This paper seeks to explore doctors' treatment decisions made without parental consent when managing adolescents presenting with sexual and reproductive health issues.
Methods: Based on a qualitative approach, in-depth interviews with 25 doctors throughout Malaysia were conducted. All audio-recorded interviews were transcribed verbatim and analyzed using a thematic approach.
Results: Generally, doctors weigh any decision by examining the health risks and benefits involved. While fear of litigation influences treatment decisions, a strong adherence to the ethical duty of 'do no harm' outweighs other considerations. When all options are risky, choosing what is considered 'the lesser of two evils,' i.e., what is perceived to be in the best interest of the adolescent, is adopted.
Conclusions: The complexity of a medical decision related to adolescent SRH issues is increased further when legal requirements are not in synch with the ethical and personal values of doctors. The laws relating to parental consent should be promulgated with a provision allowing doctors to exercise discretion in terms of treating specific SRH issues without parental consent.
METHODS: This cross-sectional study in a tertiary hospital in Kuala Lumpur, Malaysia involved parents of children with asthma. Parents of children without asthma were the control group. Eleven validated video clips showing wheeze, stridor, transmitted noises, snoring or normal breathing were shown to the parents. Parents were asked, in English or Malay, "What do you call the sound this child is making?" and "Where do you think the sound is coming from?"
RESULTS: Two hundred parents participated in this study: 100 had children with asthma while 100 did not. Most (71.5 %) answered in Malay. Only 38.5 % of parents correctly labelled wheeze. Parents were significantly better at locating than labelling wheeze (OR 2.4, 95 % CI 1.64-3.73). Parents with asthmatic children were not better at labelling wheeze than those without asthma (OR1.04, 95 % CI 0.59-1.84). Answering in English (OR 3.4, 95 % CI 1.69-7.14) and having older children with asthma (OR 9.09, 95 % CI 3.13-26.32) were associated with correct labelling of wheeze. Other sounds were mislabelled as wheeze by 16.5 % of respondents.
CONCLUSION: Parental labelling of wheeze was inaccurate especially in the Malay language. Parents were better at identifying the origin of wheeze rather than labelling it. Physicians should be wary about parental reporting of wheeze as it may be inaccurate.