Can mediation avoid litigation in conflicts about medical treatment for children? An analysis of previous litigation in England and Wales

Abstract

Objective: To investigate the reasons why parents disagree with their clinicians in cases reaching the court and to estimate the number of cases in which mediation might have avoided litigation.

Design: Analysis of 83 published cases regarding medical treatment decisions for children initiated either by an NHS Trust or Local Authority between 1990 and 1 July 2022.

Results: The analysis found that the main areas of contention are different value judgements, different interpretations of observable events such as the health of the child, their quality of life or burden of treatment and relational issues (ie, loss of trust). More than half of the cases are estimated not to have been preventable by mediation because either no conflict existed (n=13) or the parental decision was based on strongly held, mostly faith-based, views unlikely to be open for discussion (n=31).

Conclusion: The potential of mediation to avoid future litigation may be more limited than hoped for.

Keywords: Child Health; Ethics; Paediatrics; Qualitative research.