unschooling, medical decisions and older kids

[kathymuggle]

…..Philosophical discussion for fun…..

This conversation is meant to be among RU (not a term I like - but it fits the bill - those who apply USing to their whole life) or those who are seriously thinking about RU. 

Does RU extend to medical decisions?  Does your child get to decide if and when to undergo medical procedures?

A few examples to get the ball rolling - anything else you can think of to add to the discussion is fine.  None of these examples are personal.

1.  You and several orthodontists think your daughter is a good candidate for braces.  You have had several "second opinions", the issue is not going to resolve itself..what do you do?  Does DD get the final say (she is 12) on whether or not to get braces?  She knows if she does not get them now, she might end up paying for them as an adult herself.  

2.  Your daughter (also age 12) wants the HPV vaccine.  You are not so sure.  The readings you have done are not convincing you of the safety.  DD is afraid of cancer, and disagrees with you on the risk of the vaccine.  You think she has doen a little research on the topic, but not as much as you.  What do you do?  do you sign the consent form?

3.  Your DS goes to school.  He likes it, but has serious trouble with attention that might be affecting his grades.  The teacher and doctor have suggested Ritalin, which did seemed to be working, but your son did not like the side effects.  He is happy with his "C" grades, but you are worried about how these marks might affect his future.  You have tried alternative ways to help him focus but nothing works like the Ritalin does.  

Personally, I believe kids should get a lot of say in medical decisions.  It is their body.  I do believe in discussing issue with the kids, but try to be cognizant of when discussing becomes badgering, and I do believe in taking "no" for an answer.  

I think whether something is elective or necessary does come into it, but knowing what is necessary and what is elective is truly tricky.  Take Ritalin for example:  some people would put it in the necessary category (that it addresses a chemical imbalance in the brain ) and some would so it is not necessary - people can absolutely live without it.  

Thoughts, anyone?

[4evermom]

1. Orthodontia - Yes, that's ds's decision (and he does need braces). His bite is good but his front tooth is very crooked. I suppose there are more extreme cases where a very bad bite will lead to other problems and it's better to address that sooner than later. But I'm guessing most orthodontia can wait until adulthood or be skipped entirely.

2. Vaccines - I decided not to give ds any vaccines back when he was a baby. He concurs. I'd do more research with him if he was wanting some at this age (11). I can't imagine he'd want one associated with deaths to prevent a far off possibility of cancer. I'd probably make him wait if he wanted something like that and see if he still feels the same in a few years. But I'm pretty sure he'd agree with my POV anyway. Any reason the HPV must be given at age 14? I can see myself saying you can make that decision for yourself when you are 18 even though I do think kids should have significant input into medical decisions. There are so many scare tactics surrounding vaccines which I think put kids at a disadvantage for making an informed choice. 

3. Ritalin for a C student - I'd let my ds make that decision, too. I regret being so worried about grades when I was a student. I regret taking the college prep classes over things like Industrial Arts (AKA "Shop"). I'd respect that the side effects might not be worth the benefits.

[zebra15]

Quick answers here

1. Braces can wait. Braces do not fall into the 'necessary' category.

2. If she wants the vax and can make a decent argument for it then ok.  I'm not sure about the timing on HPV vax does it need to be done at 12??  Can it wait til 16 18?

3.Not every kid is going to be on honor roll.  My "C" grades got me into a very good undergrad school, then onto a masters program and even more schooling in my 30's. I don't put too much weight into high school.

[rightkindofme]

I'm not really a RU (more of a groovy unschooler than a radical unschooler) but I will be polite and hopefully that's ok too. :)

1. Orthodontia-- totally my kid's decision. I "should" have braces as an adult. I should have had them as a child. I figure I can eat and I'm not in so much pain it is ruining my life so my teeth are fine. I don't see any need to push other people towards this unless they are incapable of eating.

2. I come from the radical sex community. I know a lot of people who were part of pilot programs for that vaccine in particular (including adult men who were technically "off label") and I would permit my child to make that decision. I don't plan to do it automatically--but I will let my girls decide. For me the important bit is I won't force them into a decision that is ostensibly about their sexual health. Uhm, not my place.

3. No way in heck would I force a child onto medication so that the school system likes them better. :( I used to teach. I think that kids need to be met where they are and helped to understand their body. Drugging children into compliance seems like a good way of ensuring that they never truly learn how to function. C's get degrees.

[kathymuggle]

Originally Posted by rightkindofme 

I'm not really a RU (more of a groovy unschooler than a radical unschooler) but I will be polite and hopefully that's ok too. :)

Absolutely!  I do not call myself RU either (I am more consensual living than RU)  I just did not want the thread invaded by those who actively dislike RU or US.

[kathymuggle]

I will answer later - but thanks for all of the above answers!

I often feel odd man out in my beliefs - I am feeling a little less isolated reading these responses.  

[moominmamma]

1. Totally the child's decision. Any possible negative repercussions would fall on the child in later life and be almost entirely in the financial or cosmetic realm. No biggie.

2. Child's decision. But ... assuming she is not on the verge of becoming sexually active I would ask her to wait, since her risk of HPV is zero if she's not having sex. Another couple of years will give another couple of years of research to solidify data concerning long-term risks and benefits.

We opted to give our kids the vaccines for potentially-fatal childhood illnesses but not to give them any others. We wanted them to be able to make the decisions for themselves on those. We arbitrarily suggested that age 13 (or any time after that) was a good point to make those decisions. I think we chose age 13 because statistically chicken pox (one the vaccines we didn't give) tends to become a more serious illness once one is in the 'teens and adults' demographic. Anyway, that's one of the "becoming a teenager" rites of passage my kids have had: they can make the choice to get the Varivax, and it's also a good point for them to start considering the vaccines for STIs like Hepatitis and HPV. All three of my teens failed to get the chicken pox disease as kids, and all three opted to get the vaccine at 13. Middle dd has decided to get the Gardasil (anti-HPV) vaccine. She's now 14, not sexually active, and plans to get it sometime in the next year. She got the Hepatitis B vaccine this year. There was no rush to do either of these at age 11 or 12, because she wasn't at risk of becoming sexually active. She's spacing them out, which I think is a good choice. Elder dd opted not to get the Gardasil. Her choice. She's almost 19 but may still change her mind.

3. Child's decision. Here in the company of unschoolers I can say that I do not believe that "success in school" as defined by grades is nearly as crucial a determinant of a child's future as is normally suggested. However, I would suggest that ongoing vigorous energy be spent on identifying and implementing alternative non-pharmaceutical coping mechanisms so that *learning* can be optimized. 

Miranda

[SweetSilver]

nm

"older kids"

right.....

[kathymuggle]

Originally Posted by SweetSilver 

nm

"older kids"

right.....

You can answer if you like…or enjoy the popcorn.  I just wanted to avoid people talking about how their 2 year old was not old enough to decide if he wanted antibiotic.   

[rightkindofme]

Originally Posted by kathymuggle 

You can answer if you like…or enjoy the popcorn.  I just wanted to avoid people talking about how their 2 year old was not old enough to decide if he wanted antibiotic.   

My two year old walks around asking for "medicine" all the time. I don't even know what she means by this. It is kind of hilarious (in my head) to think of the possible consequences of just listening to her. "Do you mean this kind? This kind? This kind? Oh heck. Take 'em all!"

I think I'm funny. But I don't give my kid extra medicine. I just think about it. And laugh. HAHAHAHAHA

[kathymuggle]

Originally Posted by rightkindofme 

I think I'm funny. But I don't give my kid extra medicine. I just think about it. And laugh. HAHAHAHAHA

Well, 2 years old are cute!  

My 10 year old thinks antibiotics taste like "poo" and has told me so repeatedly.  I have asked her how she knows they taste like poo - so I can sneak some logic into her anti-antibiotics diatribe.

I do make her take antibiotics if she has them prescribed for her, btw.  We do not seek out doctors or prescriptions for fluffy reasons; if I have filled the prescription  for antibiotics it is because she genuinely needs them.  

[kathymuggle]

1.  Like everyone else here, I think it is something I would not consider without buy-in from the child/teen - even if their teeth are quite bad. 

2.  Vaccines are messy.  I brought up HPV as it was a vaccine older kids and teens typically get - things like MMR are given before kids are capable of consenting or not, and thus are parental decisions - but any vaccine an older child/teen would get falls under this umbrella.  It is very tricky for me - I am non-vax (not up for debate here!) so I know I am biased a bit when it comes to this information…just as I expect a pro-vax parent would be biased towards vaxxing.   Trying not to insert my beliefs into decisions that should be theirs is hard to do.  I am not even sure it is possible.  Ah, well, thus far they have no interest in vaxxing or making an informed choice about vaxxing, so it is all good.  I would insist on an informed choice in any medical decision they make under 18.  Does insisting on informed choice make me non RU, lol?

3.  I pretty much agree with what everyone else and it is so refreshing. 

[SweetSilver]

In some ways for me and at the age my girls are (6 and 8) it is more the absence of dissent that I look for, not approval.  If I meet resistance, I take into consideration 1) their reasons for protesting, 2) their ability to comprehend what the issues are, and 3) the seriousness of the decision.  

 In that light, I have let my oldest reject advice from the orthodontist that she get primary teeth pulled to make room for very large secondary teeth in a small jaw.  She didn't want to, even though her mouth aches from time to time.  She couldn't even sit still for anesthetic for a routine filling.  I let that one go, too, because they were suggesting a general anesthetic for a minor cavity in a primary tooth.  Even the promise that pulled teeth are worth $5 each in tooth fairy money didn't convince her. 

I allowed them to first postpone temporarily and then indefinitely their booster shots.  It began with extreme needle shyness (can you blame them?)  I asked their ARNP whether the 4-6yo boosters were timed because immunity was actually running out, or simply to catch everyone up in time for school.  It was an important question for me as a HSer, but she wasn't able to give me a straight answer--I don't think she really knew.  So, I embarked on some belated research and came to be at peace with my decision to wait until they are 11 to revisit the issue--when their understanding of the problem moves beyond the point of the needle.

Would I sign a consent form for a new vaccine that is implicated in deaths?  I'd need more research into the HPV vaccine.  It might go against #3 IMO.  But perhaps they would have a good understanding of what is at stake in making this decision, and then I would quite possibly.  Having had several abnormal paps, 2 colposcopies and a LEEP procedure, probably due to HPV, this is an issue I care about deeply.  Thankfully I have several more years to research it and consider it.

Recently I bulldozed my way into having dd2 take a hemoglobin test at her 6-year well-child visit.  She is an extremely picky eater, and I had been suspicious about her moods recently.  She passed the test easily.  I think I have a major misunderstanding about how the body uses iron if this girl has normal levels in her blood.  Anyhow, it relieved my stress about letting her take charge of her food choices.  She told me she didn't think she was brave enough.  I said she was, and I asked her which hand was her bravest.  So sweet.  She was quite proud of herself.  

This was the girl who was sent to the emergency room via ambulance for her reaction to an antibiotic shot she needed for a fast-moving cellultis on her ankle.  (I didn't allow that decision into her court.)  Poor girl.  Right at first I thought it was an anaphylactic reaction, which was why we went to the hospital, but it was decided that it was "just" a vagal response.  A blood test, which sent her throwing up in anxiety.  More needles.  Sigh!   Even I felt like it was all beyond my control, I can't imagine how she felt.

I'm letting my oldest brush her teeth with salt water.  She is a very diligent brusher, I just wish she wouldn't fight me so much about brushing twice a day or more.  But what can you do?  Hold her down?  Start ticking off the penalties?  As HSers, we have no get-out-the-door routine, and that makes it difficult to tie it to anything in order to make it routine.  Another decision with far-reaching implications.  

Drugs?  Well, the Ritalin example just wouldn't cut it for me, as an USer, but my dad has been on and off various medications for mental health issues (including psychotic episodes) and I take the issue seriously.  Also, there are the recent findings that tie some drugs routinely given to older children to suicidal thoughts.  That complicates things from the other direction-- would I prevent my teenager from taking a drug to help with mental issues knowing that suicidal thoughts and suicide are both side effects?  

[4evermom]

Originally Posted by SweetSilver Also, there are the recent findings that tie some drugs routinely given to older children to suicidal thoughts.  That complicates things from the other direction-- would I prevent my teenager from taking a drug to help with mental issues knowing that suicidal thoughts and suicide are both side effects?  

Watching daytime tv, we see a lot of ads for medicine. Hearing all the side effects that they are required to mention in the ads has made quite an impression on ds, especially one for an anti depressant that says "may cause thoughts of suicide in children and young adults." I'm glad he understands medicine isn't a magic cure all. That deciding to take it is a matter of weighing the benefits and possible side effects...

[rightkindofme]

I'm unusually paranoid about medications. I have a lot of mental health issues (I uhh mention that a lot so I'm sure people already know *Cough*) and I've been on a lot of different medications over the years. Most of them were against my will when I was a teenager. I am incredibly hostile to the idea of putting my kids on drugs unless it is COMPLETELY NECESSARY. It is interesting the things that make me feel like they are necessary when other people don't think they are necessary. Like vaccines. I'm a selective vaccinator because I take my kids out of the country a lot. I flat told their pediatrician that if we traveled less they would be entirely unvaccinated. In a few years we are going to work on farms in third world countries where medical care may or may not be available. I worry about the diseases that could kill them without immediate treatment and vaccinate for those. It feels like a small risk that they would happen to get, say measles, but we were traveling in the midst of a huge measles outbreak and going through airports where there were known cases being passed around. 

It's really interesting trying to predict the future because that is how all of this stuff feels for me.

I feel like I am walking somewhere between RU, consensual living, and vague paternalism. I worry. I worry a lot. I have a lot of voices in my head that tell me THE RIGHT WAY TO BE. And I spend a lot of time stomping on those voices and not repeating the message. I worry that I won't be good at teaching them the things they need to know in order to make good decisions. I feel like most people make bad decisions because they don't have enough experience or insight to make a good decision not because they want to make a bad decision.

I'm very interested in how the next 15 years play out. I wonder how I actually will handle my kids as they get older. I'm trying really hard not to be controlling. It's interesting. Which decisions do I have to make? 

Interesting. :)

[pek64]

No guess necessary for me, since my son is a teen.

We said "no" to braces, and his jaw did grow and his teeth are straightening on their own.

He agrees with me about vaccine safety issues, and has no interest in getting the HPV vaccine.

One of the reasons I chose to homeschool was to avoid the ADHD diagnosis and Ritalin. It's doubtful I ever would have had him take it if he *had* gone to school.


You are feeling like the odd person among ... who? Relatives? Friends?

[kathymuggle]

Originally Posted by pek64 
.
We said "no" to braces, and his jaw did grow and his teeth are straightening on their own.

Both my sister and I were told we needed braces as teenagers.  My parents could not afford them so we did not get them.  My teeth are fine ( my teeth did straighten out as I grew) and my sister is fairly snaggle-toothed.

My middle does have braces as her teeth really were quite crooked.  It was hard for me to OK them (even though she wanted them) as I have this history where my own teeth did straighten naturally.  However her teeth were more crooked than I remember mine ever being, so it seemed a good choice for her.  I do think going through the process of discussing the pros and cons of orthodontia, looking at different apparatuses and visiting several orthodontists before deciding what to do modeled making an informed choice in a positive real-life way.  We have also had some discussions about finances, and about beauty standards and how much we want to buy into such things. 

One of the reasons I chose to homeschool was to avoid the ADHD diagnosis and Ritalin. It's doubtful I ever would have had him take it if he *had* gone to school.

This has always been at the back of my mind. My oldest is (almost more "was" - he has bloomed in recent years) very spacey. I know some schools are good at dealing with such things, but truthfully I have some reservations on how schools in this area handle kids they think are ADHDish.  They do push drugs, and almost all the kids I know who have ADHD or an IEP for any reason (and I know a fair bit) are streamed into less challenging work.  It is not what I wanted for my son, and I did not want to spend oodles of time fighting the school over what I think is the correct path.  There are numerous other reasons we HS/US - but this was one of them.

You are feeling like the odd person among ... who? Relatives? Friends?

Friends, somewhat.  It just seems like our culture is very interventionist, and it seems typical for people to spout off that parents should decide everything "because they are the parents"

Edited by kathymuggle - 1/7/13 at 11:14am

[pek64]

I had to get two teeth filled when I was a teen because "they were going to end up with cavities, anyway", and I wish I had been given a say, since it was *my* mouth. That probably influenced me.

I have had more problems with relatives, regarding my choices, than friends. Of course, friends who disagreed tended to just drift away. And I was comfortable with that. I'm sorry you're feeling out of place. More of our friends we met through the natural food store, where we shop. They are more tolerant of different choices, since some are vegetarian, and some are vegan, while the rest are omnivores. So maybe realizing and accepting food differences makes them more willing to accept other differences, too.