Even though there is implied consent when a child is abandoned, an infant who was left at an apartment complex in Houston spent several days at Texas Children’s Hospital while the issue of consent was being investigated, he notes. The burden is on the ED to verify that no parent is available to give consent and the intention was to abandon the child, says Weltge. O ED staff still will have to make an effort to obtain consent. "There is a lot of emotional impact invested which potentially jeopardizes the care of other patients." That type of scenario also tends to lead to an outpouring of emotion among ED staff, he says. "ED staff will spend time on potentially unnecessary tests and utilize expensive and unnecessary resources on the child in the ED until illness can be excluded and abandonment established." Because the law doesn’t require that the mother provide any information about the child, a major investment of time and resources will be needed, he notes. Although the Texas law states that the child needs to be left at a licensed emergency medical service provider to prevent prosecution of the mother, it apparently gives the mother permission to leave the child anywhere "relatively" safe, which might include the hospital bathroom or doorway, says Weltge. O Children might be left in other hospital locations. An infant could get these tests unnecessarily if there is any suspicion that the child could be sick."Ī child born to a mother who was addicted to drugs or alcohol will appear to be ill and would warrant extensive tests if there is no background history available, he says. "This includes blood cultures, X-rays, and a spinal tap, because infections can easily be overwhelming at this age. "So a healthy child potentially may be subjected to a number of unnecessary tests."įor example, infants may have a septic evaluation to determine any life-threatening problems such as infections, Weltge says. "A newborn infant or neonate less than a month old can have many life-threatening yet relatively unapparent problems," he says. If you have no information about an abandoned child, your primary obligation is to look for life-threatening injuries or illnesses, says Weltge.
"There is no requirement that the mother leave either a note of intention that this child is being given up or a note that the child is well and has no medical problems," he says. The law removes all responsibility from the mother to provide any information about the abandoned child, notes Weltge. O No information is available about the child. It’s important to note the pros and cons of the Texas law, so you can use the information to provide input on legislation in your state, Weltge advises. But the law, with good intentions, has potentially created problems for the child and emergency services." "No one wants to see abandoned children left in unsafe places, such as dumpsters. In Houston, 13 abandoned children were found last year, notes Weltge. "The ACEP board will also develop a recommendation for its state chapters as to involvement in legislative efforts," she says. "Surprisingly, there is a lack of awareness of the law on the part of EDs and EMS agencies," he says.ĪCEP is developing a policy to educate the emergency medicine community about its role in this area and to encourage providers to be adequately prepared to take on that role, reports Susan Nedza, MD, FACEP, chair of the state legislative and regulatory committee for the Dallas-based American College of Emergency Physicians (ACEP) and an ED physician at Elmhurst (IL) Memorial Hospital. But whatever your opinion, you and your staff need to be informed, notes Arlo Weltge, MD, MPH, FACEP, associate professor of emergency medicine at University of Texas Houston Medical School. Similar legislation has been introduced in several states, including Delaware, Alabama, California, Minnesota, and Georgia.ĮD providers line up on both sides about whether such laws are a good idea. Texas passes law - other states might followĪre you prepared to handle a newborn infant abandoned in your ED? A controversial law recently passed in Texas that allows mothers to drop off infants 30 days old or younger anonymously to an emergency medical services provider.
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