McDougall Rosalind J, Notini Lauren
J Med Ethics. 2014 Jul;40(7):448-52. doi: 10.1136/medethics-2013-101446.
This paper reviews the ethical literature on conflicts between health professionals and parents about medical decision-making for children. We present the results of a systematic review which addressed the question 'when health professionals and parents disagree about the appropriate course of medical treatment for a child,under what circumstances is the health professional ethically justified in overriding the parents' wishes?’ We identified nine different ethical frameworks that were put forward by their authors as applicable across various ages and clinical scenarios. Each of these frameworks centred on a different key moral concept including harm,constrained parental autonomy, best interests, medically reasonable alternatives, responsible thinking and rationality.
本文回顾了关于医疗专业人员与家长在儿童医疗决策方面存在冲突的伦理文献。我们展示了一项系统综述的结果，该综述探讨了“当医疗专业人员与家长在儿童适当的治疗方案上存在分歧时，在何种情况下医疗专业人员违背家长意愿在伦理上是合理的？”这一问题。我们确定了九个不同的伦理框架，其作者提出这些框架适用于不同年龄和临床场景。这些框架中的每一个都围绕着一个不同的关键道德概念，包括伤害、受限的家长自主权、最大利益、医学上合理的替代方案、负责任的思考和理性。
