- CHICAGO (AP) - Children and teens who are infected with the AIDS virus
should be told, the nation's foremost group of pediatricians says.
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- "It's better to approach it in a
controlled fashion rather than have a 12-year-old overhear it on the ward:
`The child with AIDSin bed No. 3,''' said Dr. Robert Pantell of the University
of California at San Francisco.
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- Pantell is one of the authors of a policy
statement from the American Academy of Pediatrics published in the January
issue of the journal Pediatrics.
-
- The 55,000-member organization recommended
frankness toward HIV-infected children. It said doctors should try to work
with the patient's parents to convince them their child should know the
truth.
-
- But it stopped short of saying doctors
should tell the child over the parents' objections, unless the patient
is a sexually active teenager.
-
- The academy said the best way to tell
the child is with both doctors and parents present. But it acknowledged
some parents may want the doctor to break the news.
-
- It said some doctors have often bowed
to the wishes of parents who hope to keep youngsters from knowing they
have HIV. The reasons include fear that their youngsters will lose their
will to live, become angry with parents who infected them or disclose the
information outside the family.
-
- The academy has not previously taken
a position on the issue. Doctors said the problem is becoming more serious
as the number of youngsters with HIV grows and they live longer.
-
- As of a year ago, there were more than
8,000 reported cases of AIDS in children under 13. The vast majority got
the infection from their mothers at birth, and well over half remain alive,
doctors said.
-
- The statement cautioned that only preliminary
research has been done on the effect of telling youngsters about their
condition. But the pediatricians said an initial study shows that those
who are told have higher self-esteem and parents who are candid with children
are less likely to be depressed.
-
- Health-care professionals who did not
participate in writing the statement largely agreed.
-
- "Time and time again we have seen
that we think we are sparing the children from something and all we have
done is make it more mysterious and more frightening because we were unwilling
to talk about it,'' said Dr. Thomas DeStefani, chairman of pediatrics at
Loyola University Medical Center.
-
- Dr. Hermann Mendez, a professor of pediatrics
at the State University of New York at Brooklyn, echoed the statement's
authors in saying that the time and manner of disclosure should match the
patient's personality and readiness to know the truth.
-
- "If the child is unable to keep
information that belongs in the family within the family, this could result
in harm to the family,'' he said.
-
- The statement said that teen-agers, who
may be sexually active, must be told the truth to prevent spread of the
infection. It said preschoolers are usually interested mainly in what will
happen in their immediate future and don't necessarily need to hear the
whole diagnosis.
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