Court-mediated disputes between physicians and families over the medical care of children.

Objective: To describe the judiciary's approach to parent-physician disputes over the care of sick children.

Data Sources: Court publications.

Study Selection: Fifty parent-physician disagreements over the care of children led to physician requests for court intervention and resulted in judicial opinions published by the court. The opinions describe 66 children from 20 states.

Data Synthesis: Physicians prevailed at the initial decision in 44 (88%) of the 50 disputes and at the final decision in 40 disputes (80%). Physicians were more likely to prevail in religion-based disputes than in other cases (27 of 30 vs 13 of 20; P<.03), but they were less likely to prevail in disputes concerning life-threatening or potentially disabling conditions (23 of 31 vs 17 of 19; P<.19). Courts acknowledged the pediatric patients' views in only 10 of the disputes (9 of the 19 cases involving adolescents and 1 of the 31 cases involving children younger than 12 years). For most courts, the petitioning physicians provided the only source of scientific information.

Conclusions: Published court opinions create precedents for future decisions and provide insight into the consequences of seeking court intervention for the physician who encounters parental refusal of care.