Doctor, please do not hurt my child

“The difference between taking children seriously and merely loving them or caring about them, resides in whose concerns about the children’s well-being take precedence: the children’s or the adults’. Conventional wisdom tries to blur this distinction by portraying children’s concerns as somehow less valid or less significant than those of adults.”
– Chris Swift and Kolya Wolf


      

From the archives: First published in Taking Children Seriously 25, 1998

The difference between taking children seriously and merely loving them or caring about them, resides in whose concerns about the children’s well-being take precedence: the children’s or the adults’. Conventional wisdom tries to blur this distinction by portraying children’s concerns as somehow less valid or less significant than those of adults. This explains why the majority of parents, who routinely ride roughshod over their children’s sensibilities, are so often shocked to hear their behaviour described as ‘coercive’. The unspoken rationale here is that as children are not fully fledged moral beings, compelling them to do what is in their own best interest cannot constitute coercion.

This line of argument is not unique to traditionally minded parents. It has also been employed by tyrants down the ages: if you want to impose your will on someone, first assert that they are morally and psychologically inferior to you. Such arguments have frequently been used to justify the oppression of slaves, women, members of religious or ethnic minorities, homosexuals, and of course children.

A concrete example of this phenomenon in the present day can be found in the medical profession’s attitude towards children’s pain. Try asking your doctor whether he or she is willing to treat your child in such a way as to avoid causing unnecessary pain, for instance in the course of giving injections. If you do, you are liable to hear a catalogue of arguments that would be universally condemned as outrageous if applied to any other group of people. You may be told that 

  1. the proposed procedure does not hurt,
  2. children don’t feel pain in the same way as adults,
  3. the pain in question is insignificant compared with that incurred in the course of everyday mishaps,
  4. children’s pain is soon forgotten,
  5. anæsthetics are less effective on children than on adults,
  6. children need to be hardened to the sensation of pain,
  7. sparing children pain only spoils them,

and so on.

In addition to encountering this supposedly authoritative rebuttal of your concerns, you may also provoke a surprising degree of hostility. This is because the doctor may (reasonably) draw the conclusion that his refusal to cooperate with your request renders him, in your eyes, incompetent at best, and a lying, heartless bastard at worst. The situation is not improved by the fact that doctors have a legal monopoly on prescribing effective anæsthetics. These factors, combined with the traditional tendency to be deferential towards doctors, can make this problem difficult to solve in practice.

For this reason we are taking this opportunity to summarise our own experience in dealing with this problem. We have adopted a policy of always offering our daughter the use of local anæsthetic prior to being subjected to any potentially painful procedure such as an injection. To this end, and with some difficulty, we have persuaded a doctor (not our regular doctor) to prescribe EmlaÒ cream. This is a powerful local anaesthetic containing 2.5% Lignocaine and 2.5% Prilocaine.

So far we have only had to use it in connection with immunisation injections. The procedure we follow is to apply the cream to the proposed site of the injection—usually the front of the upper thigh—at least two hours in advance, having first marked the site with an indelible pen. The cream is applied in a thick layer, covered with cling-film, and secured around the perimeter with Micropore or other adhesive surgical tape. The dressing and any remaining cream are then removed immediately prior to the injection. Of course, even with the pain of the injection suppressed, the child may still find the whole experience frightening. This, too, needs to be addressed. Therefore it is important to seek out a practitioner who has a rapport with small children.

Emla is apparently unsuitable for babies less than 12 months old. This posed a problem for us in regard to the initial series of vaccinations which the medics wanted to start at two or three months. Our solution was to wait until our daughter was one year old.

In addition to always offering her pain relief, we have also allowed her to watch whenever we have had injections or other medical procedures ourselves. Our hope is that she will learn that while moderate pain can be endured without anæsthetic, it is up to her to decide when, if ever, she wishes to put this to the test.

It goes without saying that we apply the same policy to dental treatment, which can, and should, be entirely painless. Fortunately we have a dentist who is more than willing to work this way. Harder problems may arise in the future if some more complex medical procedure is called for, or in the event of an emergency. But come what may, we are resolved to fight for out daughter’s right not to be hurt by doctors or nurses no matter how strongly they believe it to be for her own good. 

See also:

Chris Swift and Kolya Wolf, 1998, ‘Doctor, please do not hurt my child’, Taking Children Seriously 25, ISSN 1351-5381, pp. 6-7, https://www.takingchildrenseriously.com/doctor-please-do-not-hurt-my-child

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