ALLEGATION #

DEFINITION

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Death

Permanent cessation of all vital functions.

The following definitions of death are also commonly used:

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Total irreversible cessation of cerebral function, spontaneous function of the respiratory system, and spontaneous function of the circulatory system.

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The final and irreversible cessation of perceptible heart beat and respiration.

Verification of death must come from a physician or coroner.

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Head Injuries

Head Injury

As used in this Part, head injury means a serious head injury causing skull fracture, brain damage or bleeding on the brain, such as subdural hematoma or shaken baby syndrome.  The following are considered head injuries:

Brain Damage

Brain Damage means injury to the large, soft mass of nerve tissue contained within the cranium skull.

Skull Fracture

Skull Fracture means a broken bone of the skull.

Hematoma

Hematoma means a swelling or mass of blood (usually clotted) confined to an organ, tissue or space and caused by a break in a blood vessel.

Subdural Hematoma

Subdural means beneath the dura mater (the outer membrane covering the spinal cord and brain).

A subdural hematoma is located beneath the membrane covering the brain and is usually the result of head injuries or the shaking of a small child or infant.  It may result in the loss of consciousness, seizures, mental or physical damage, or death.

Shaken Baby Syndrome (Whiplash Shaken Infant Syndrome (WSIS))

Shaking of an infant causes stretching and tearing of blood vessels in the brain causing subdural hematoma, bleeding in the brain and retinal hemorrhage.

Verification of head injuries must come from a physician, preferably a neurosurgeon or radiologist.

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Internal Injuries

An internal injury is an injury which is not visible from the outside, e.g., an injury to the organs occupying the thoracic or abdominal cavities. Such injury may result from a direct blow or a penetrating injury.  A person so injured may be pale, cold, perspiring freely, have an anxious expression, or may seem semicomatose.  Pain is usually intense at first, and may continue or gradually diminish as patient grows worse.

Verification of internal injuries must come from a physician.

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Burns

Burns

Tissue injury resulting from excessive exposure to thermal, chemical, electrical or radioactive agents.  The effects vary according to the type, duration and intensity of the agent and the part of the body involved.  Burns are usually classified as:

– First Degree (Partial Thickness)

Superficial burns, damage being limited to the outer layer of the epidermis (skin).  Characterized by scorching or painful redness of the skin.

– Second Degree (Partial Thickness)

The damage extends through the outer layer of the skin into the inner layers (dermis).  Blistering will be present within 24 hours.

– Third Degree (Full Thickness)

Burns in which both layers of the skin (epidermis and dermis) are destroyed with damage extending into underlying tissues, which may be charred or coagulated.

– Fourth Degree (Full Thickness)

Burns extend beyond skin and underlying tissues into bone, joints and muscles.

Scalding

A burn to the skin or flesh caused by moist heat and hot vapors, as steam.

All emersion burns (scalds) must be confirmed by a physician unless the alleged perpetrator has admitted to scalding the child.

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Poison/Noxious Substances

Poison

Any substance, other than mood altering chemicals or alcohol, taken into the body by ingestion, inhalation, injection, or absorption that interferes with normal physiological functions.  (Virtually any substance can be poisonous if consumed in sufficient quantity; therefore, the term poison more often implies an excessive amount rather than the existence of a specific substance.)

Noxious

Harmful, injurious, not wholesome.

Verification must come from a physician or by a direct admission from the alleged perpetrator.

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Wounds

A gunshot or stabbing injury.

Verification must come from a physician, a law enforcement officer or by a direct admission from the alleged perpetrator.

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Bone Fractures

A fracture is a broken bone.

Metaphyseal – Epiphyseal Fractures

Fractures at the end of bones.  They are commonly described as corner fractures, chipped fractures or bucket-handle fractures.

Diaphyseal Fractures

Diaphyseal fractures are located in the bone shaft.  Fractures in the shaft of long bones of the extremities are spiral (oblique) or transverse.  Spiral fracture is caused by twisting or rotational force.  Transverse fracture results from a direct blow or bending force.

Verification must come from a physician or radiologist.

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Substantial Risk of Physical Injury/Environment

Injurious to Health and Welfare

Substantial risk of physical injury means that the parent, caregiver, immediate family member aged 16 or over, other person residing in the home aged 16 or over, or the parent's paramour has created a real and significant danger of physical injury that would likely cause disfigurement, death, or impairment of physical health or loss or impairment of bodily functions (abuse).  This allegation of harm is to be used when the type or extent of harm is undefined but the total circumstances lead a reasonable person to believe that the child is in substantial risk of physical injury.  This allegation of harm also includes incidents of violence or intimidation directed toward the child that have not yet resulted in injury or impairment but that clearly threaten such injury or impairment (abuse) or placing a child in an environment that is injurious to the child's health and welfare (neglect).

Examples of incidents or circumstances that place the child in substantial risk of physical injury include, but are not limited to, the following:

Incidents of Maltreatment

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choking the child (abuse).

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smothering the child (abuse).

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pulling the child's hair out (abuse).

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violently pushing or shoving the child into fixed or heavy objects (abuse).

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throwing or shaking a smaller child (abuse).

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other violent or intimidating acts directed toward the child that cause excessive pain or fear (abuse).

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situations that place a child at substantial risk of harm due to environmental issues in the home (neglect).

Circumstances

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domestic violence in the home when the child has been threatened and the threat is believable, as evidenced by a past history of violence or uncontrolled behavior (neglect).

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a perpetrator of child abuse who has been court ordered to remain out of the home returns home and has access to the abused child (abuse).

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anyone living in the home has a documented history of violence toward children (abuse).

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the circumstances surrounding the death of one child provides reason to believe that another child is at real and significant danger of physical injury (neglect).

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anyone in the home exposes child to environment that significantly affects the health and safety based on use, sale or manufacturing of illegal drugs or alcohol (neglect).

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parent's or caretaker's mental illness and behavior poses a significant danger to the child's health and safety (neglect).  To indicate an allegation based on this factor, the investigator must rule out dependency as defined in the Juvenile Court Act as the presenting problem.

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parent has been adjudicated unfit by a court and the parent has not completed services that would correct the conditions which led to the court finding (abuse/neglect).

Factors to be Considered

Whether there is a real and significant danger to justify taking a report is determined by the following factors (All factors need not be present to justify taking the report.  One factor alone may present sufficient danger to justify taking the report.):

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the child's age.

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the child's medical condition, behavioral, mental, or emotional problems, developmental disability, or physical handicap, particularly related to his or her ability to protect himself or herself.

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the severity of the occurrence.

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the frequency of the occurrence.

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the alleged perpetrator's physical, mental and/or emotional abilities, particularly related to his or her ability to control his or her actions.

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the dynamics of the relationship between the alleged perpetrator and the child.

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the alleged perpetrator's access to the child.

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the previous history of indicated abuse or neglect.

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the current stresses/crisis in the home.

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the presence of other supporting persons in the home.

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Cuts, Bruises, Welts, Abrasions and Oral Injuries

Cut

An opening, incision or break in the skin made by some external agent.

Bruise

An injury that results in bleeding under the skin, where the skin is discolored but not broken.  Also referred to as a contusion.

Welt

An elevation on the skin produced by a lash, blow, or allergic stimulus.  The skin is not broken and the mark is reversible.

Abrasion

A scraping away of the skin.

Oral Injuries

Injuries to the child's mouth, including broken teeth.

Factors to be Considered

Not every cut, bruise, or welt constitutes an allegation of harm.  The following factors should be considered when determining whether an injury which resulted in cuts, bruises or welts constitute an allegation of harm:

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the child's age (children aged 6 and under are at a much greater risk of harm).

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child's medical condition, behavioral, mental, or emotional problems, developmental disability, or physical handicap, particularly as they relate to the child's ability to seek help.

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pattern or chronicity of similar incidents.

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severity of the cuts, bruises, welts, or abrasions (size, number, depth, extent of discoloration).

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location of the cuts, bruises, welts, or abrasions.

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whether an instrument was used on the child.

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previous history of indicated abuse or neglect.

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Human Bites

A bruise, cut or indentation in the skin caused by seizing, piercing, or cutting the skin with human teeth.

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Sprains/Dislocations

Sprain

Trauma to a joint that causes pain and disability depending upon the degree of injury to ligaments and/or surrounding muscle tissue.  In a severe sprain, ligaments and/or muscle tissue may be completely torn.  The signs are rapid swelling, heat and disability, often discoloration and limitation of function.

Dislocation

The displacement of any part, especially the temporary displacement of a bone from its normal position in a joint.  Types include:

Complicated

A dislocation associated with other major injuries.

Compound

Dislocation in which the joint is exposed to the external air.

Closed

A simple dislocation.

Complete

A dislocation which completely separates the surfaces of a joint.

Verification must come from a physician, registered nurse, licensed practical nurse or by a direct admission from the alleged perpetrator.

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Tying/Close Confinement

Unreasonable restriction of a child's mobility, actions, or physical functioning by tying the child to a fixed (or heavy) object, tying limbs together or forcing the child to remain in a closely confined area which restricts physical movement.  Examples include, but are not limited to:

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locking a child in a closet or small room.

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tying one or more limbs to a bed, chair, or other object, except as authorized by a licensed physician.

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tying a child's hand behind his or her back.

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putting a child in a cage.

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Substance Misuse

Option A

The consumption of a mood altering chemical capable of intoxication to the extent that it harmfully affects the child's health, behavior, motor coordination, judgment, or intellectual capability.  Mood altering chemicals include cannabis (marijuana), hallucinogens, stimulants (including cocaine), sedatives (including alcohol and Valium), narcotics, or inhalants (abuse/neglect).  Abuse occurs if the parent provides the substance to the child.  Neglect occurs if the parent allows the use or fails to protect the child from consumption.

Option B

Fetal alcohol syndrome or drug withdrawal at birth caused by the mother's addiction to drugs is included in this definition and is considered child neglect (neglect).

Option C

Any amount of a controlled substance or a metabolite thereof, found in the blood, urine or meconium (newborn's first stool) of a newborn infant.  A controlled substance is defined in subsection (f) of Section 102 of the Illinois Controlled Substances Act [720 ILCS 570/102] (neglect).  The presence of such substances shall not be considered as child neglect if the presence is due to medical treatment of the mother or infant.

NOTE:

Methadone withdrawal or other withdrawal verified as under the auspices of a drug treatment program is not included under drug withdrawal at birth.

Examples of substance misuse include, but are not limited to:

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giving a minor (unless prescribed by a physician) any amount of heroin, cocaine, morphine, peyote, LSD, PCP, pentazocine, or methaqualone or encouraging, insisting, or permitting a minor's consumption of the above substances.

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giving any mood altering substance, including alcohol or sedatives, unless prescribed by a physician, to an infant or toddler.

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encouraging, insisting or permitting a child who has not reached puberty to consume alcohol, drugs, or another mood altering substance on a regular or frequent basis.

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encouraging, insisting or permitting an adolescent to consume alcohol, drugs, or another mood altering substance on a daily basis.

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encouraging, insisting or permitting any minor to become intoxicated by alcohol, drugs, or another mood altering substance even if on an infrequent basis.

Factors to be Considered

The following factors should be considered when determining whether a child is involved in substance misuse:

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age of the child.

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frequency of substance misuse.

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amount of substance consumption.

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whether the substance is illegal for general population use.

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degree of behavioral dysfunction, or physical impairment linked to substance misuse.

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the child's culture, particularly as it relates to use of alcohol in religious ceremonies or on special occasions.

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whether the parent or caregiver's attempts to control an older child's substance misuse or to seek help for the child's substance misuse were reasonable under the circumstances.

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whether the parent or caregiver knew or should have known of the child's substance misuse.

16

Torture

Inflicting or subjecting the child to intense physical and/or mental pain, suffering, or agony that is severe, repetitive, increased, or prolonged.

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Mental and Emotional Impairment

Injury to the intellectual, emotional or psychological development of a child as evidenced by observable and substantial impairment in the child's ability to function within a normal range of performance and behavior, with due regard to his or her culture.

Verification that a child has been mentally injured must come from a medical doctor, psychiatrist, registered psychologist, certified social worker, registered nurse or a therapist or counselor of a community mental health agency.

18

Sexually Transmitted Diseases

A disease which was acquired originally as a result of sexual penetration or sexual conduct with an individual who is afflicted with the disease.  The diseases may include, but are not limited to:

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Acquired Immune Deficiency Syndrome (AIDS)

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Balanoposthitis

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Calymmatobacterium Granulomatis

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Chancroid

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Chlamydia Trachomatis

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Genital Herpes

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Genital Warts

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Gonorrhea

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Granuloma Inquinale

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Haemophilus Ducreyi

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HIV Infection

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Lymphogranuloma Venereum

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Neisseria Gonorrhea

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Nonspecific Urethritis

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Proctitis

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Syphilis

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Treponema Pallidum

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Trichomonas Vaginalis (Symptomatic)

Sexual penetration is defined in the Illinois Criminal Sexual Assault Act as "any contact, however slight, between the sex organ or anus of one person by an object, the sex organ, mouth or anus of another person, or any intrusion, however slight, of any part of the body of one person or any animal or object into the sex organ or anus of another person, including but not limited to cunnilingus, fellatio or anal penetration."

Sexual conduct is defined in the Act as "any intentional or knowing touching or fondling of the victim or the perpetrator, either directly or through clothing of the sex organs, anus or breast of the victim or the accused, or any part of the body of a child…for the purpose of sexual gratification or arousal of the victim or the accused."

Verification of sexually transmitted diseases must come from a medical source.

19

Sexual Penetration

Any contact, however slight, between the sex organ or anus of one person by an object, the sex organ, mouth or anus of another person, or any intrusion, however slight, of any part of the body of one person or any animal or object into the sex organ or anus of another person.  This includes acts commonly known as oral sex (cunnilingus, fellatio), anal penetration, coition, coitus, and copulation.

20

Sexual Exploitation

Sexual use of a child for sexual arousal, gratification, advantage, or profit.  This includes but is not limited to:

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indecent solicitation of a child/explicit verbal enticement.

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child pornography.

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exposing sexual organs to a child for the purpose of sexual arousal or gratification.

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forcing the child to watch sexual acts.

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self-masturbation in the child's presence.

NOTE:

Sexual penetration and molestation are excluded from this allegation.  They are listed as separate allegations.

21

Sexual Molestation

Sexual conduct with a child when such contact, touching or interaction is used for arousal or gratification of sexual needs or desires.  Parts of the body, as used in the examples below, refer to the parts of the body described in the definition of sexual conduct found in the Illinois Criminal Sexual Assault Act [720 ILCS 5/12-12] as quoted above under Allegation 18, Sexually Transmitted Diseases.  Examples include, but are not limited to:

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fondling.

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the alleged perpetrator inappropriately touching or pinching parts of the child's body generally associated with sexual activity.

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encouraging, forcing, or permitting the child to touch parts of the alleged perpetrator's body normally associated with sexual activity.

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Substantial Risk of Sexual Injury

Substantial risk of sexual injury means that the parent, caregiver, immediate family member, other person residing in the home, or the parent's paramour has created a real and significant danger of sexual abuse, in that:

Option A

An indicated, registered, or convicted sex offender has significant access to children, and the extent/quality of supervision during contact is unknown or suspected to be deficient.

Option B

There are siblings or other children in the same household as the alleged offender of a current allegation of sexual abuse.

Option C

Persistent, highly sexualized behavior or knowledge in a very young child (e.g., under the age of five chronologically or developmentally) that is grossly age inappropriate, and there is reasonable cause to believe that the most likely manner in which this behavior or knowledge was learned is in having been sexually abused.

Note:  When accepting a report based on behavioral indicators, State Central Register staff must inform the reporter that the report cannot be indicated unless the victim makes a statement regarding specific sexual abuse or a forensic evaluation or independent consultation results in a clinical finding of sexual abuse.

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Inadequate Supervision

The child has been placed in a situation or circumstances that are likely to require judgment or actions greater than the child's level of maturity, physical condition, and/or mental abilities would reasonably dictate.  A child shall not be considered neglected for the sole reason that  the child's parent or other person responsible for this or her welfare has left the child in the care of an adult relative for any period of time [325 ILCS 5/3].  Examples include, but are not limited to:

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leaving children alone when they are too young to care for themselves.

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leaving children alone who have a condition that requires close supervision.  Such conditions may include medical conditions, behavioral, mental, or emotional problems, or developmental or physical disabilities.

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leaving children in the care of an inadequate or inappropriate caregiver.

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being present but unable to supervise because of the caregiver's condition (This includes (1) the parent or caregiver who repeatedly uses drugs or alcohol to the extent that it has the effect of producing a substantial state of stupor, unconsciousness, intoxication or irrationality and (2) the parent or caregiver who cannot adequately supervise the child because of his or her medical condition, behavioral, mental, or emotional problems, or a developmental or physical disability).

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leaving children unattended in a place that is unsafe for them when their maturity, physical condition, and mental abilities are considered.

Factors to be Considered

The following factors should be considered when determining whether a child is inadequately supervised.

Child Factors

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child's age and developmental stage, particularly related to the ability to make sound judgments in the event of an emergency.

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child's physical condition, particularly related to the child's ability to care for or protect himself or herself.  Is the child physically or mentally handicapped, or otherwise in need of ongoing prescribed medical treatment such as periodic doses of insulin or other medications?

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child's mental abilities, particularly as related to the ability to comprehend the situation.

Caregiver Factors

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presence or accessibility of caregiver.

○

How long does it take the caregiver to reach the child?

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Can the caregiver see and hear the child?

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Is the caregiver accessible by telephone?

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Has the child been given phone numbers to call in the event of an emergency?

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caregiver's capability.

○

Is the caregiver mature enough to assume responsibility for the situation?

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Does the caregiver depend on extraordinary assistance to care for self and the child, i.e., meal preparation, laundry, grocery shopping, transportation?  Is the caregiver without consistent or reliable assistance?

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Is the child assuming primary care giving duties, i.e., meal preparation, laundry, grocery shopping, transportation?

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caregiver's physical condition.

○

Is the caregiver physically able to care for the child?  Do the caregiver's own health needs present serious obstacles to the care and well-being of the child?

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caregiver's cognitive and emotional condition.

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Is the caregiver able to make appropriate judgments on the child's behalf?

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Do the caregiver's own health needs present serious obstacles to the care and well-being of the child?

Incident Factors

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frequency of occurrence.

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duration of the occurrence (as related to the "child factors" above).

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time of the day or night when the incident occurs.

child's location (the condition and location of the place where the minor was left without supervision).

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the weather conditions, including whether the minor was left in a location with adequate protection from the natural elements such as adequate heat or light.

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other supporting persons who are overseeing the child.  (Was the child given a phone number of a person or location to call in the event of an emergency and whether the child was capable of making an emergency call?)

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whether food and other provisions were left for the child.

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other factors that may endanger the health and safety of the child.

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Abandonment/Desertion

Abandonment

Abandonment is parental conduct which demonstrates the purpose of relinquishing all parental rights and claims to the child.  Abandonment is also defined as any parental conduct which evinces a settled purpose to forego all parental duties and relinquish all parental claims to the child.

Desertion

Desertion is any conduct on the part of a parent that indicates an intention to terminate custody of the child but not to relinquish all duties to and claims on the child.

Examples of abandonment/desertion include, but are not limited to, parents who:

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leave a baby on a doorstep.

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leave a baby in a garbage can.

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leave a child with no apparent intention to return.

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leave a child with an appropriate caregiver but fail to resume care of the child, as agreed, and the caregiver cannot or will not continue to care for the child.

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Inadequate Food

Lack of food adequate to sustain normal functioning.  It is not as severe as Malnutrition or Failure to Thrive, both of which require a medical diagnosis.

Examples include:

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the child who frequently and repeatedly misses meals or who is frequently and repeatedly fed insufficient amounts of food.

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the child who frequently and repeatedly asks neighbors for food and other information substantiates that the child is not being fed.

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the child who is frequently and repeatedly fed unwholesome foods when his age, developmental stage, and physical condition are considered.

Factors to be Considered

Child Factors

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child's age.

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child's developmental stage.

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child's physical condition, particularly related to the need for a special diet.

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child's mental abilities, particularly related to his ability to obtain and prepare his own food.

Incident Factors

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frequency of the occurrence.

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duration of the occurrence.

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pattern or chronicity of occurrence.

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previous history of occurrences.

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availability of adequate food.

77

Inadequate Shelter

Lack of shelter that is safe and that protects the children from the elements.

Examples of inadequate shelter include, but are not limited to:

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no housing or shelter

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condemned housing.

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exposed, frayed wiring.

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housing with structural defects that endanger the health or safety of a child.

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housing with indoor temperatures consistently below 50º F.

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housing with broken windows in sub-zero weather.

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housing that is a fire hazard obvious to the reasonable person.

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housing with an unsafe heat source that poses a fire hazard or threat of asphyxiation.

Factors to be Considered

Child Factors

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child's age.

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child's developmental stage.

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child's physical condition, particularly when it may be aggravated by the inadequate shelter.

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child's mental abilities, particularly related to the child's ability to comprehend the dangers posed by the inadequate shelter.

Shelter Factors

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seriousness of the problem.

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frequency of the problem.

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duration of the problem.

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pattern or chronicity of the problem.

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previous history of shelter-related problems.

78

Inadequate Clothing

Lack of appropriate clothing to protect the child from the elements.

Factors to be Considered

Child Factors

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child's age.

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child's developmental stage.

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child's physical condition, particularly related to conditions that may be aggravated by exposure to the elements.

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child's mental abilities, particularly related to his or her ability to obtain appropriate clothing.

Incident Factors

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frequency of the incident.

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duration of the incident.

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chronicity or pattern of similar incidents.

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weather conditions such as extreme heat or extreme cold.

79

Medical Neglect

Medical or Dental Treatment

Lack of medical or dental treatment for a health problem or condition that, if untreated, could become severe enough to constitute a serious or long-term harm to the child; lack of follow-through on a prescribed treatment plan for a condition that could become serious enough to constitute serious or long-term harm to the child if the plan goes unimplemented.

Factors to be Considered

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child's age, particularly as it relates to the ability to obtain treatment.

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child's developmental stage.

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child's physical condition.

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seriousness of the current health problem.

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probable outcome if the current health problem is not treated and the seriousness of that outcome.

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generally accepted medical benefits of the prescribed treatment.

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generally recognized side effects/harms associated with the prescribed treatment.

It must be verified that the child has/had an untreated health problem, or that a prescribed treatment plan was implemented.  Such verification must come from a physician, registered nurse, dentist, or by a direct admission from the alleged perpetrator.  It must further be verified by a physician, registered nurse or dentist that the problem or condition, if untreated, could result in serious or long-term harm to the child.

81

Failure to Thrive (Non-Organic)

A serious medical condition most often seen in children under one year of age.  The child's weight, height and motor development fall significantly short of the average growth rates of normal children (i.e., below the fifth percentile).  In about 10% of these cases, there is an organic cause such as a serious kidney, heart, or intestinal disease, a genetic error of metabolism or brain damage.  All other cases are a result of a disturbed parent-child relationship manifested in severe physical and emotional neglect of the child.  Non-organic failure to thrive requires a medical diagnosis before it may be indicated.

Verification of failure to thrive must come from a physician.

82

Environmental Neglect

The child's person, clothing, or living conditions are unsanitary to the point that the child's health may be impaired.  This may include infestations of rodents, spiders, insects, snakes, etc., human or animal feces, rotten or spoiled food or rotten or spoiled garbage that the child can reach.

Factors to be Considered

Special attention should be paid to the child's physical condition and the living conditions in the home in order to determine whether the report constitutes an allegation of harm.  In addition, the following factors should be considered.

Child Factors

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child's age (children aged 6 and under are more likely to be harmed).

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child's developmental stage.

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child's physical condition.

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child's mental abilities.

Incident Factors

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severity of the conditions.

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frequency of the conditions.

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duration of the conditions.

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chronicity or pattern of similar conditions.

83

Malnutrition  (Non-Organic)

Lack of necessary or proper food substances in the body caused by inadequate food, lack of food, or insufficient amounts of vitamin or minerals.  (Also known as marasmus or kwashiorkor.) Non-organic malnutrition requires a medical diagnosis before it may be indicated.  There are various physical signs of malnutrition:

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a decrease in lean body mass or fat; very prominent ribs; the child may often be referred to as skin and bones.

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the hair is often sparse, thin, dry, and is easily pulled out or falls out spontaneously.

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the child is often pale and suffers from anemia.

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excessive perspiration, especially about the head.

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the face appears lined and aged, often with a pinched and sharp appearance.

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the skin has an old, wrinkled look with poor turgor. (Classically, skin folds hang loose on the inner thigh and buttock).

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the abdomen is often protuberant.

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there are abnormal pulses, blood pressure, stool patterns, intercurrent infections, abnormal sleep patterns and a decreased level of physical and mental activity.

Verification of malnutrition must come from a physician.

84

Lock-Out

The parent or caregiver has denied the child access to the home and has refused or failed to make provisions for another living arrangement for the child.

85

Medical Neglect of Disabled Infants

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 that is most likely to relieve or correct all life-threatening conditions and evaluations or consultations necessary to assure that sufficient information has been gathered to make informed medical decisions.  Nutrition, hydration, and medication, as appropriate for the infant's needs, is medically indicated for all disabled infants.  Other types of treatment are not medically indicated when:

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the infant is chronically and irreversibly comatose.

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the provision of the treatment would be futile and would merely prolong dying.

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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.

Factors to be Considered

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infant's physical condition.

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seriousness of the current health problem.

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probable medical outcome if the current health problem is not treated and the seriousness of that outcome.

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generally accepted medical benefits of the prescribed treatment.

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generally recognized side effects associated with the prescribed treatment.

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the opinions of the Infant Care Review Committee (ICRC) (if the hospital has an ICRC).

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the judgment of the Perinatal Coordinator regarding whether treatment is medically indicated and whether there is credible evidence of medical neglect.

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

Verification that treatment was medically indicated must come from a physician and may come from experts in the field of neonatal pediatrics.