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“你能做的任何事,我都能做得更厉害?”:关于身材正常的矮小儿童使用生长激素的伦理与公平性问题

"Anything you can do, I can do bigger?": the ethics and equity of growth hormone for small normal children.

作者信息

Gill D G

机构信息

Department of Paediatrics RCSI, Children's University Hospital, Temple Street, Dublin 1, Ireland.

出版信息

Arch Dis Child. 2006 Mar;91(3):270-2. doi: 10.1136/adc.2005.081778.

DOI:10.1136/adc.2005.081778
PMID:16492893
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2065932/
Abstract

This paper argues against the use of growth hormone (GH) for small normal children ("idiopathic" short stature) with the following considerations: ethical (philosophical) grounds, cost-economic implications, and the rationale for treating normal physiological variation with a potent pharmacological agent. The author would prefer to see health and economic resources being directed to correct nutritional and environmental deprivation among underprivileged groups in preference to providing GH injections for small normal children.

摘要

本文基于以下几点考虑,反对给正常身材矮小的儿童(“特发性”身材矮小)使用生长激素(GH):伦理(哲学)依据、成本-经济影响,以及使用强效药物治疗正常生理变异的基本原理。作者更希望看到健康和经济资源用于纠正弱势群体中存在的营养和环境匮乏问题,而不是给正常身材矮小的儿童注射生长激素。

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本文引用的文献

1
Growth hormone (GH) treatment to final height in children with idiopathic short stature: evidence for a dose effect.生长激素(GH)治疗特发性身材矮小儿童至最终身高:剂量效应的证据。
J Pediatr. 2005 Jan;146(1):45-53. doi: 10.1016/j.jpeds.2004.08.055.
2
Height and social adjustment: are extremes a cause for concern and action?身高与社会适应:身高极端情况是否值得关注并采取行动?
Pediatrics. 2004 Sep;114(3):744-50. doi: 10.1542/peds.2003-1169-L.
3
The psychological burden of short stature: evidence against.身材矮小带来的心理负担:反对的证据。
Eur J Endocrinol. 2004 Aug;151 Suppl 1:S29-33. doi: 10.1530/eje.0.151s029.
4
hGH for short stature: ethical issues raised by expanded access.
J Pediatr. 2004 May;144(5):648-52. doi: 10.1016/j.jpeds.2004.02.028.
5
Growth hormone: uses and abuses.生长激素:用途与滥用情况
BMJ. 2004 Apr 17;328(7445):907-8. doi: 10.1136/bmj.328.7445.907.
6
Growth hormone treatment for idiopathic short stature: implications for practice and policy.
Arch Pediatr Adolesc Med. 2004 Feb;158(2):108-10. doi: 10.1001/archpedi.158.2.108.
7
Incidence of diabetes mellitus and impaired glucose tolerance in children and adolescents receiving growth-hormone treatment.接受生长激素治疗的儿童和青少年中糖尿病及糖耐量受损的发病率。
Lancet. 2000 Feb 19;355(9204):610-3. doi: 10.1016/S0140-6736(99)04055-6.
8
Growth hormone therapy for the short normal child: who needs it and who wants it? The case against growth hormone therapy.
J Pediatr. 2000 Jan;136(1):103-6. doi: 10.1016/s0022-3476(00)90058-1.
9
Growth hormone use in normal, short children--a plea for reason.在正常矮小儿童中使用生长激素——呼吁理性对待。
N Engl J Med. 1999 Feb 18;340(7):557-9. doi: 10.1056/NEJM199902183400710.
10
Moral assessment of growth hormone therapy for children with idiopathic short stature.特发性身材矮小儿童生长激素治疗的道德评估
J Med Ethics. 1997 Oct;23(5):305-9. doi: 10.1136/jme.23.5.305.