Taking sick children seriously

From the archives: Posted on 6th December, 1997

A poster wrote:

“A child (almost 4) has a fever of 103. You want to reduce the fever by using Tylenol or a tepid bath. These options are rejected by the child. The medicine doesn’t taste good; with the child’s agreement, you try mixing it with juice. Unacceptable. You buy a different kind of medicine hoping the taste will be better – it’s not. He does agree to a little sponge bath, but the fever doesn’t come down. You talk about the body getting too hot and wanting to help cool it down. The child says firmly that he is all better now.

I don’t seem to be very creative with solutions. I can’t seem to get beyond these thoughts:

a) maybe it’s not true that a high fever must be reduced, or maybe 103 isn’t a high fever (but all my home medical books say otherwise)

b) maybe the child isn’t rational because of prior coercion (if only I had been a better parent, he would trust me enough to take medicine when I say it is important)

c) maybe the child isn’t rational because of a high fever

d) maybe a refusal to take medicine doesn’t mean a child’s not rational

I’m not particularly happy with any of these thoughts (well, except d)”

d is definitely true!

a and b could be true. c sounds most unlikely (if he’s delirious he’s unlikely to have the wherewithal to lie appropriately).

“and, thanks to the influence of this list, no longer able to just go ahead with the idea that I know better, that’s the way it is, and the child will take it for his own good. But I don’t seem to be able to come up with a better way to think about this.”

Well – now it’s the next day, and your child has recovered. He has survived, as you knew he would, and he feels OK now, and you are happy about that. Because you did not force him to endure unpleasant sensations against his will, you succeeded in making him as happy as you knew how, during the illness. You are happy about that too. By sticking to a non-coercive style, you have also given him a number of health benefits for the future – for instance when he is ill he can take comfort, untainted by fear, in your presence. If you hadn’t slightly overstepped the mark (as evidenced by his presumably lying when he said that he is ‘all better now’) he’d also get another important benefit, namely that he wouldn’t be tempted in future to lie to you about how he feels. That would have made you happy too.

So what exactly (and I mean exactly) are you unhappy about?

Is it that if this had been a life-and-death situation, and he had overridden your advice in the way he did on this occasion, then he’d be dead by now? Or rather, that you’d have coerced him by now, and therefore there must be something wrong with non-coercive educational theory? If it is that, then you surely see that it doesn’t make sense. In fact you didn’t believe that his life was at stake, so why should he behave as if it were? You told him the facts as best you knew them; you gave him your best advice; he used your advice as he thought best, and came to a decision which (from what you say) seems to have been the right one. Why have you concluded that something is wrong? Why don’t you conclude instead that the combined system of you plus your child, when operating rationally (non-coercively), is better at making decisions that you alone would be, and that your child’s life is safer as well as happier as a result of these better decisions.

Is it that you fear – what if? What if he had died of overheating and you had not forced him to take the medicine that might have cooled him and saved his life? So now you’d feel for the rest of your life that you were a bad mother and had killed your own child. Is that what you think? Or is it what you think other people would think? Anyway, if that were really the source of your worry, that would be an argument for monitoring his temperature carefully; for phoning a doctor and asking what the danger level is, and so on. If you didn’t do those things, then (as I said above) I guess that you didn’t really fear he was going to die or suffer permanent harm.

So, I repeat, what was it, and what is it, that you are unhappy about? What exactly was tempting you to force unpleasant sensations on an already suffering child?

David Deutsch, 1997, ‘Taking sick children seriously’, https://www.takingchildrenseriously.com/taking-sick-children-seriously/