Library: Policy

340:75-3-430. Protocol for investigating alleged medical neglect of infants born alive and infants born with disabilities

Issued 7-1-13

     Withholding needed medical treatment from an infant born alive at any stage of development or an infant born with disabilities is prohibited by state and federal statutes and regulations.  Withholding medical treatment is the failure to respond in any manner to an infant born alive and failure to respond to the infant's life‑threatening conditions by providing treatment that, in the treating physician's reasonable medical judgment, will most likely improve or correct such conditions.

• (1) When treatment is not required.  Providing treatment to the infant born with disabilities is not required when, in the physician's reasonable medical judgment, any of the following circumstances exist:

  • (A) the infant is chronically and irreversibly comatose;

  • (B) provision of treatment would merely prolong dying; or

  • (C) provision of treatment would be virtually futile in terms of the infant's survival and the treatment itself would be inhumane.

• (2) Reports of medical neglect of the infant born alive and of the infant born with disabilities.  Reports alleging the person responsible for the child (PRFC) has denied the infant born alive or the infant with disabilities medically beneficial treatment, including nutrition and hydration are investigated by OKDHS.

• (3) Reports of medical neglect of the infant born alive or of the infant born with disabilities by a medical provider.  Reports alleging the medical provider has denied medically beneficial treatment to a child or infant born alive or an infant born with disabilities is investigated by the Office of Client Advocacy.  • 1

• (4) Protocol for investigating alleged medical neglect of infants born alive and infants with disabilities.  The protocol for investigating reports of alleged medical neglect of an infant born alive or an infant born with disabilities is the same as other investigations of reported child abuse or neglect by a person responsible for the child.  • 2

INSTRUCTIONS TO STAFF 340:75-3-430

1.Reports of medical neglect of an infant born alive or an infant born with disabilities.The Child Protective Services (CPS) Programs Unit and the appropriate district director are notified immediately when a report alleges medical neglect by a medical provider.CPS Programs Unit personnel refer the report to the Office of Client Advocacy for disposition.

2.Investigative protocol.Investigations alleging medical neglect by a person responsible for the child's (PRFC) health, safety, or welfare of an infant born alive or born with disabilities is expeditiously investigated utilizing investigative protocol, when possible.The child welfare (CW) specialist:

(1) obtains as much information as possible regarding the:

(A) infant's condition, including diagnosis and prognosis; and

(B) basis for the reporter's statement that medically indicated treatment is being or will be withheld;

(2) interviews the person who made the report to review the concerns or allegations and obtain additional information;

(3) immediately phones the hospital to determine what information is available regarding the infant's status;

(4) arranges interviews, when needed, with the responsible physician and others involved in the treatment as quickly as possible;

(5) obtains information regarding the diagnosis, prognosis, and recommended treatment from appropriate medical personnel by:

(A) interviewing the treating physician, specialist, and other medical personnel;

(B) attending the medical staffing;

(C) reviewing medical records;

(D) obtaining independent medical advice or examinations by non-treating physicians to determine if exemptions to treatment exist; and

(E) consult with Child Welfare Services nurses;

(6) when there is difficulty accessing hospital or pertinent records, requests the district attorney seek a court order directing access;

(7) interviews each parent and others to obtain relevant information, including treatment decisions and the reasons for the decision;

(8) refers for additional guidance to Oklahoma Administrative Code (OAC) 340:75-3-120 Instructions to Staff # 23 regarding withholding medical treatment from an infant born alive at any stage of fetal development or with disabilities and # 27 about PRFC's decision to treat medical issues through spiritual means;

(9) when medically indicated treatment is or will be withheld from the infant, attempts to resolve the situation by discussing the concerns with the parent.

(A) When medically indicated treatment is withheld, the infant's condition requires an urgent response, and efforts to obtain parental consent for treatment have failed, procedures in OAC 340:75-3-300 are followed.

(B) When a court order for emergency medical treatment is necessary, the parent and responsible physician are promptly notified of the court's decision;

(10) when there is difficulty obtaining an emergency order or deprived petition, promptly contacts the CPS Programs Unit to obtain Legal Services assistance.