An open letter to warring parents

I don't think I've posted this particular lament before, but if I have then I apologize for the repetition. That said, some things bear repeating.

To all divorced/separated/estranged parents:

Your children are not appropriate proxies for your war against each other. There is no context or situation in which it is appropriate for you to use your child as a vector to enact revenge against your former spouse/partner. This is true as a general rule (exceptions to which I cannot conceive) and in the particular case of medical care. When one of you uses the plan I have made for your child with the other to frustrate him or her by refusing to administer medication (one common example), you are failing your child and wasting my time.

In cases where the medication is clearly indicated, your objection is moot. I will not stop treating objective medical findings because you have not observed them yourself. In cases where you refuse to administer treatments you do not like because you were not present for the visit where they were prescribed, I will simply document this decision and may contact child protective authorities if the condition is appropriately severe. Even if I do not deem it necessary to inform the state, I will gladly provide said documentation for consideration in future custody disputes. Thankfully, most of you seem to grasp the importance of treatment in these circumstances, and so this kind of meddling is rare.

For the care of vaguer, more subjective diagnoses, it is easier for you to get away with this kind of nonsense. Many parents in good faith have qualms with giving their children medication for such things as anxiety or ADHD. You may be motivated to large degree by such qualms, which are not objectionable per se. However, if your former spouse/partner disagrees with you, it is contingent upon the two of you to do right by your child and work that out before the appointment has been made. This is part of being grown-up, and by doing so you demonstrate to your child that your love for him/her is more important than your hatred for each other. If you absolutely, positively cannot come to an agreement before the appointment has been made, then you should both come in for the visit and explain your observations, concerns and objections. I will do my part by allotting sufficient time for the visit, and by listening seriously to both of you. I will do my best to create a plan that best approximates an acceptable compromise for all involved.

If you find out about a decision to which you object ex post facto, I understand your frustration if you did not know about the appointment in advance. (The corollary here is that you have an obligation to each other to be in appropriate communication with each other, no matter how much you may hate the sound of each other's voice. This is why God gave us e-mail and text messaging.) However, as much as it may chafe that you were not involved in this decision, calling my office (or having your legal representative do so) is a step I would urge you to avoid. As vague and subjective as the diagnosis of ADHD (a typical area of contention) may be, it is a diagnosis I have made upon review of as much information I can collect. I would not have agreed to start a medication if I had not decided it was indicated based upon my own best judgement. No matter how valid the point you may be making about your prerogatives in this situation, you are also quite likely depriving your child of a treatment that could genuinely help with his or her ability to function in school.

Regardless of how you and your ex choose to make decisions, I cannot and will not function as an arbiter between the two of you. If it is clear the two of you are stuck at an impasse, and neither of you is willing to budge for the sake of your child, it leaves me with nothing to do but wash my hands of the situation. (Again, in cases where treatment is clearly necessary, I will not bow to your objection and will proceed with whatever is medically indicated. You can explain to a judge why you would like a court order blocking me.) It makes no sense to try to manage a patient's care when one parent countermands the decisions of the other, and I won't waste my time. You are free to schedule an appointment when the two of you have decided that your petty squabbles aren't worth the well-being of your child any longer.