Haque Malika
Clinical Professor of Pediatrics, College of Medicine, The Ohio State University, Pediatrician, Nationwide Children's Hospital, Pediatric Consultant, Bureau of Disability and Social Security, Medical Director, Noor Community Free Clinic, Columbus, Ohio.
J IMA. 2011 Dec;43(3):192-4. doi: 10.5915/43-8973.
Dealing with end-of-life issues in pediatric patients is difficult due to their young age, the complexities of situations leading to illness, and the multiple decision makers that exist in addition to parents and guardians. Pediatric patients do not have living wills addressing specific instructions for how long to continue life support systems such as a ventilator or a G-tube (gastrostomy tube for feeding). The dying pediatric patient also has typically not consented to organ donation either. The burden of decision making lies with the parents, guardians, and health-care providers of the dying child. This paper deals with these complexities and reflects the author's own experiences over nearly four decades of dealing with pediatric patients in her practice.
由于儿科患者年龄小、导致疾病的情况复杂，以及除父母和监护人之外还存在多个决策者，处理儿科患者的临终问题很困难。儿科患者没有生前预嘱来指明维持生命支持系统（如呼吸机或胃造口管用于喂食）的具体时长。濒死的儿科患者通常也未同意器官捐赠。决策的重担落在濒死儿童的父母、监护人和医疗服务提供者身上。本文探讨了这些复杂问题，并反映了作者在近四十年的临床实践中处理儿科患者的亲身经历。
