Saugstad O D, Nygaard R
Barneklinikken og Pediatrisk forskningsinstitutt Rikshospitalet, Oslo.
Tidsskr Nor Laegeforen. 1990 Jun 20;110(16):2084-7.
There should be a special obligation to shield children with a terminal illness from pain and from the psychological suffering when death is approaching. In spite of this, the child has the right to be informed about the prognosis and decisions taken concerning treatment. We discuss the difficult question of informed consent in pediatrics. Who can make an informed consent on behalf of a minor? At which age should a child make its own decisions concerning medical treatment? In pediatrics there are certain circumstances where withdrawal of intensive medical care is justified. Examples are given from oncological and neuromuscular diseases, as well as from the neonatal period. We discuss how termination of intensive care could take place. The medical team should make the decision alone, but should never go against the parents' will. It is underlined that termination of intensive care in the above-mentioned circumstances is completely different from active euthanasia, which we strongly oppose.
对于身患绝症且濒临死亡的儿童，应当承担特殊的义务，保护他们免受疼痛和心理折磨。尽管如此，儿童有权了解预后情况以及有关治疗的决策。我们讨论儿科中知情同意这一难题。谁能代表未成年人做出知情同意？儿童在什么年龄应该自己做出有关医疗治疗的决定？在儿科领域，存在某些情况下停止强化医疗护理是合理的。文中给出了肿瘤学和神经肌肉疾病以及新生儿期的例子。我们讨论了如何实施重症监护的终止。医疗团队应独自做出决定，但绝不能违背父母的意愿。需要强调的是，在上述情况下终止重症监护与我们坚决反对的主动安乐死完全不同。
