Mouradian W E, Omnell M L, Williams B
Children's Hospital and Regional Medical Center, Dept. of Pediatrics, University of Washington School of Medicine, Seattle 98105-0371, USA.
Angle Orthod. 1999 Aug;69(4):295-9. doi: 10.1043/0003-3219(1999)069<0295:EFO>2.3.CO;2.
When treating children, important ethical issues may arise relating to the best interests of the child and decision making for minors. The case of a child with a cleft lip and palate whose parents failed to bring her in for medically indicated orthodontic care is presented. Ethical features of the case are discussed, including the need to benefit the patient, avoid harm, and respect the preferences of the parents. Ethical codes of the American Dental Association and American Medical Association are referenced. Ethical dilemmas include the conflict between the orthodontist's obligation to the child and the need to respect parental autonomy. Parental autonomy is respected up until the point at which significant harm to a child may result. The orthodontist's primary ethical responsibility is to the child, not the parents. The orthodontist providing medically indicated care should involve the craniofacial team or hospital social worker when parental decision making is in question.
在治疗儿童时，可能会出现与儿童的最大利益以及未成年人决策相关的重要伦理问题。本文介绍了一名唇腭裂患儿的案例，其父母未带她接受医学上建议的正畸治疗。讨论了该案例的伦理特征，包括使患者受益、避免伤害以及尊重父母偏好的必要性。引用了美国牙科协会和美国医学协会的伦理准则。伦理困境包括正畸医生对儿童的义务与尊重父母自主权的必要性之间的冲突。在可能对儿童造成重大伤害之前，父母的自主权会得到尊重。正畸医生的主要伦理责任是对儿童，而非对父母。当父母的决策存在疑问时，提供医学上建议治疗的正畸医生应让颅面团队或医院社会工作者参与进来。
