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August 31, 2002

Other Social Issues, School and Daycare

Question from a school nurse:

I am a school nurse caring for a student with type 1 diabetes. My difficulty is that the child's father who is divorced from the mother will not give parental consent to allow me to administer the prescribed insulin at noon time. I am an experienced RN and I do not believe it is a trust issue but rather an "control" issue. There is a bitter custody battle ensuing and he does not want his daughter to have any injections while at school. The mother and doctor agree that when her blood sugar is over 250, she should receive the insulin. I cannot administer any medication without parental consent from both parents. My main concern of course is for the long-term effects this will have on this student. She often runs blood sugars over 300. Our healthcare plan is non-existent without a team effort. Do I have any recourse with an unreasonable parent? And what liability do I have in letting a known diabetic be in school without proper medical intervention when needed? The doctor's office is considering notifying DCFS. In the meantime, where do I stand?


My first and only advice must be to seek the counsel of the attorney with the school district. Some of the issues here are:

Sometimes a court awards temporary custody of the children to a parent during the custody proceeding. If it’s one parent alone, they make decisions about medical care.
Sometimes a court appoints an attorney to represent the rights of the children in a custody proceeding. If so, they should be made aware of health care and welfare issues affecting the children.
One could write a letter to the court (judge) explaining problems concerning the health and welfare of the children. The judge might issue hold a hearing at which parents would have to explain and defend their decisions into the status of the children.
One could file a complaint with the child welfare authorities.

Please go to the school district attorney and discuss these issues with him or her.

Additional comments from Dr. Stuart Brink:
File a


(Child in Need of Services)
petition or have the school lawyer handle this for you. This way, the
courts can decide who is the custodial parent and force the parents to come
to some agreement.

You should also discuss this dilemma directly with the child’s diabetes
team since they should be able to intervene as
well. If only one parent has legal custody, then you do not need both
parent’s permission. If both parents have legal custody jointly, then you
must act in the child’s best interests to the best of your ability.