The Negotiation of Medical Treatments by Parents of Children with Congenital Adrenal Hyperplasia in Poland

Abstract

Congenital adrenal hyperplasia (CAH) is a rare inherited disease that requires continuous home-based treatment. The increasing accessibility of medical information and the presence of an active online community—particularly a dedicated Facebook group—enable parents of children with CAH to become engaged participants in discussions about therapy and innovative solutions. Drawing on ethnographic research, this study explores the complex dynamics of medical decision-making and negotiation between parents and doctors. Key areas of contention include: 1. Medication dosage. 2. The use of cortisol pump technology. 3. The availability of emergency hydrocortisone injection kits. 4. Early genital surgery. While parents actively seek knowledge and challenge medical approaches, their influence on biomedical practices remains limited. The study argues that these negotiations, though often subtle and slow, contribute to changing treatment and become the part of the “logic of care”.