Whilst on prac in paediatrics I was assessing a 3 year old girl with foetal alcohol syndrome (FAS). The clinic I was in meant that this was a one-off assessment rather than ongoing treatments and appointments. During my subjective assessment I was horrified when her mother confirmed what I had read in the notes, that she had been drinking 48 cans of beer (yes, 2 cartons) a week for several months whilst pregnant with her daughter. She also reported that she had significantly reduced her drinking since giving birth.
I found it extremely hard not to say anything to her about my opinion of what she had done to her child and the 'life' that was given to her. My supervisor was not with me at the time and I spoke to her at length after the patient and her parents had left as I could not believe what I had heard. She did not seem ashamed to admit this either, and although 3 years had passed and she had probably told a number of health professionals before me, I still could not believe what I was hearing.
I had to restrain myself in what I said and how I said it throughout the assessment, which I was able to do by focusing on the child rather than the parents (no family-centred practice here) and focus on what the current problems were as opposed to the cause which could not be reversed. I did not feel I could possibly avoid judging this mother (or father for allowing this to occur), but felt I had to keep this judgement to myself for professionalism, but more importantly so that they would continue with the assessment and treatment their child needed.
This experience was a real wake-up call for me, and although I don't think I would do anything differently if something similar happened again, it was one of those situations where I felt that I wasn't doing the right thing at the same time. This was an extreme example of a lifestyle condition that was not the fault of the person who suffers from it, which I found far more difficult to deal with than, for example, COPD sufferers who continue to smoke.
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Reserving judgement is often impossible, especially in a situation such as the one you describe. Its so full on! I sometimes wonder whether people are just totally unaware of what they are doing, or are of the mentality 'it won't happen to me'. The poor child...although we see some wonderful things, sometimes the things we see are awful.
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