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[儿科急诊中的伦理:医疗服务可及性、沟通与保密]

[Ethics in pediatric emergencies: Care access, communication, and confidentiality].

作者信息

Benoit J, Berdah L, Carlier-Gonod A, Guillou T, Kouche C, Patte M, Schneider M, Talcone S, Chappuy H

机构信息

Groupe symposium d'Automne 2014 du DES de pédiatrie d'Île-de-France, France.

Urgences pédiatriques, université Pierre-et-Marie-Curie, hôpital Armand-Trousseau, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France.

出版信息

Arch Pediatr. 2015 May;22(5):554-61. doi: 10.1016/j.arcped.2015.02.013. Epub 2015 Mar 31.

Abstract

Children suffer most from today's increasing precariousness. In France, access to care is available for all children through various structures and existing measures. The support for foreign children is overseen by specific legislation often unfamiliar to caregivers. Pediatric emergencies, their location, organization, actors, and patient flow are a particular environment that is not always suitable to communication and may lead to situations of abuse. Communication should not be forgotten because of the urgency of the situation. The place of the child in the dialogue is often forgotten. Considering the triangular relationship, listening to the child and involving the parents in care are the basis for a good therapeutic alliance. Privacy and medical confidentiality in pediatric emergencies are governed by law. However, changes in treatments and medical practices along with the variety of actors involved imply both individual and collective limitations, to the detriment of medical confidentiality.

摘要

儿童受当今日益不稳定状况的影响最大。在法国,所有儿童都可通过各种机构和现有措施获得医疗服务。对外国儿童的支持由护理人员通常不熟悉的特定立法监管。儿科急诊、其地点、组织、相关人员和患者流程是一个特殊环境,并不总是适合交流,可能导致虐待情况。不应因为情况紧急而忘记沟通。儿童在对话中的地位常常被忽视。考虑到三角关系,倾听儿童意见并让父母参与护理是良好治疗联盟的基础。儿科急诊中的隐私和医疗保密受法律约束。然而,治疗和医疗实践的变化以及涉及的各种人员意味着个人和集体都存在限制,有损医疗保密。

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