@article{ref1,
title="Preventing self-harm from repeat foreign-body ingestion",
journal="Pediatrics",
year="2019",
author="Low Kapalu, Christina and Lantos, John and Booser, Adam and Thomson, Mike and Attard, Thomas",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="Mental health disorders in adolescents present some of the most challenging of all ethical dilemmas. This is particularly true when they lead to self-injurious behavior that can only be prevented by either limiting the freedom of the adolescent or forcing treatments on them that they do not want. Intentional and repeated foreign-body ingestion (FBI) in youth is a poorly understood self-injurious behavior that can be life-threatening. It poses unique clinical and ethical challenges. Ingestion of sharp or magnetic objects increases the need for endoscopic retrieval or surgical intervention with associated risks, including perforation and anesthesia-related adverse events. When behavior modification efforts fail to prevent recurrent FBI, the cumulative risk of medical intervention mounts. Sometimes, as a last resort, doctors consider surgical procedures that limit jaw movement and may physically prevent recurrent FBI. In this Ethics Rounds article, we present a case in which doctors consider whether it is in the best interest of a teenager with this behavior to undergo orthodontic jaw wiring as a next step in treatment of repeated FBI. Doctor commentary on the ethical decision-making process is provided.<br><br>Copyright © 2020 by the American Academy of Pediatrics.<p /> <p>Language: en</p>",
language="en",
issn="0031-4005",
doi="10.1542/peds.2019-1515",
url="http://dx.doi.org/10.1542/peds.2019-1515"
}