Parekh S A
University of Wales, Swansea, UK.
Child Care Health Dev. 2007 Jan;33(1):78-82. doi: 10.1111/j.1365-2214.2006.00641.x.
The law governing consent for children is not very clear. A child can consent to treatment but usually in practice is unable to refuse it. Even if both the child and parents refuse treatment, courts are reluctant to accept this, particularly if it is in the best interest of the child.
In order to consent to treatment, a child must be competent enough to do so, and this competence is judged usually by a doctor. Children can even consent to contraceptives and abortion if 'competent' to do so. This concept perfectly lacks moral, ethical and emotional competence, and judgement of competence is carried out usually purely scientifically by pure science-orientated objective professionals like doctors. A broad discussion about the issues of children refusing treatment is conducted from the legal, ethical and philosophical point of view. Life-saving treatment and various other cases are also discussed.
There is no right answer to the question. A more holistic approach is needed, and not only doctors but also sociologists, care specialists and even clergymen should be asked to judge competence in a multidisciplinary environment, particularly for contraceptives and abortion. This multidisciplinary working can be extended to other areas in medical law as well particularly in light of changes in medicine. Experience in life should be valued in a decision-making environment for judging competence. The law in relation to child consent is unclear and requires changes in order to clarify what is perceived as the child's best interest.
关于儿童同意治疗的法律并不十分明确。儿童可以同意接受治疗,但在实际操作中通常无法拒绝治疗。即使儿童和父母都拒绝治疗,法院也不太愿意接受,尤其是当这不符合儿童的最大利益时。
为了同意接受治疗,儿童必须具备足够的能力,而这种能力通常由医生来判断。如果儿童“有能力”,他们甚至可以同意使用避孕药具和堕胎。这一概念完全缺乏道德、伦理和情感能力,而能力的判断通常完全由像医生这样纯粹以科学为导向的客观专业人员从科学角度进行。从法律、伦理和哲学角度对儿童拒绝治疗的问题进行了广泛讨论。还讨论了挽救生命的治疗和其他各种情况。
这个问题没有正确答案。需要一种更全面的方法,不仅应该让医生,还应该让社会学家、护理专家甚至神职人员在多学科环境中判断能力,特别是在避孕药具和堕胎方面。这种多学科合作也可以扩展到医疗法律的其他领域,特别是鉴于医学的变化。在判断能力的决策环境中,应该重视生活经验。与儿童同意相关的法律不明确,需要进行修改以澄清什么被视为儿童的最大利益。