Neuroethics Research Unit, Institut de Recherches Cliniques de Montréal, Montréal, Quebec, Canada.
Semin Pediatr Neurol. 2013 Jun;20(2):154-9. doi: 10.1016/j.spen.2013.06.009.
Transition from pediatric to adult healthcare is a well-established challenge for individuals with neurodevelopmental disorders like cerebral palsy. With regard to ethics, some of the key aspects to explore include the following: if and how individuals feel respected during the transition process; if and how their values and preferences are developed and integrated within transition; and if and how young patients are prepared to participate in decision making (to be autonomous) within the transition. We carried out a qualitative study on 14 young adults with cerebral palsy. Some participants reported positive experiences. However, several tension points were identified, including before the transition (eg, transition envisaged with fear and apprehension); during the transition (eg, lack of cooperation or communication between providers in the pediatric and adult healthcare systems); and after the transition (eg, feelings of abandonment). We discuss the clinical influence and ethical significance of better capturing ethical values within the transition process and preparing young individuals to engage in discussions about their health and disease management.
从儿科到成人医疗保健的过渡是脑瘫等神经发育障碍患者面临的一个成熟挑战。就伦理学而言,需要探讨的一些关键方面包括:个人在过渡过程中是否感到受到尊重,以及如何受到尊重;他们的价值观和偏好是否在过渡中得到发展和整合;以及年轻患者在过渡中如何准备参与决策(自主)。我们对 14 名脑瘫青年进行了一项定性研究。一些参与者报告了积极的体验。然而,也确定了几个紧张点,包括过渡前(例如,对过渡感到恐惧和担忧);过渡期间(例如,儿科和成人保健系统的提供者之间缺乏合作或沟通);以及过渡后(例如,感到被抛弃)。我们讨论了在过渡过程中更好地捕捉伦理价值观以及使年轻人准备好参与讨论他们的健康和疾病管理的临床影响和伦理意义。