Mouradian W E
Children's Hospital and Regional Medical Center, Department of Pediatrics, University of Washington School of Medicine, Seattle 98105-0371, USA.
Angle Orthod. 1999 Aug;69(4):300-5. doi: 10.1043/0003-3219(1999)069<0300:MDFC>2.3.CO;2.
Making decisions for children is part of everyday orthodontic care. When conflicts arise between providers and parents, articulation of the ethical and legal principles guiding the process can be helpful. Parents are generally decision makers for their minor children, a presumption supported for practical and moral reasons and by legal precedent. The best interests of the child must guide both parents and providers. As the child matures, he or she should be brought into the decision making process as age and ability allow. A child's competency is a function of age, cognitive abilities, and personal experiences. The child should participate in the decision making process to facilitate trust, cooperation, and the development of future decisional capacities. The concepts of informed consent, parental permission, and child assent are compared and contrasted. Tables are provide that summarize these concepts and offer guidelines for providers working with children.
为儿童做决定是日常正畸治疗的一部分。当医疗服务提供者与家长之间出现冲突时，阐明指导这一过程的伦理和法律原则可能会有所帮助。一般来说，父母是其未成年子女的决策者，这一推定有实际和道德方面的理由以及法律先例的支持。儿童的最大利益必须指导父母和医疗服务提供者。随着孩子的成长，应根据其年龄和能力，让其参与到决策过程中。儿童的行为能力是年龄、认知能力和个人经历的函数。儿童应参与决策过程，以促进信任、合作以及未来决策能力的发展。本文对知情同意、家长许可和儿童同意的概念进行了比较和对比。文中提供了表格，总结了这些概念，并为与儿童打交道的医疗服务提供者提供了指导方针。
