TY  - JOUR
PY  - 2019//
TI  - Preventing self-harm from repeat foreign-body ingestion
JO  - Pediatrics
A1  - Low Kapalu, Christina
A1  - Lantos, John
A1  - Booser, Adam
A1  - Thomson, Mike
A1  - Attard, Thomas
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - 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>
LA  - en
SN  - 0031-4005
UR  - http://dx.doi.org/10.1542/peds.2019-1515
ID  - ref1
ER  -