Usumoto Yosuke, Sameshima Naomi, Tsuji Akiko, Kudo Keiko, Nishida Naoki, Ikeda Noriaki
Fukuoka Igaku Zasshi. 2014 Dec;105(12):234-40.
We report the case of 2-year-old girl who died of precursor B-cell acute lymphoblastic leukaemia (ALL), the most common cancer in children. She had no remarkable medical history. She was transferred to a hospital because of respiratory distress and died 4 hours after arrival. Two weeks before death, she had a fever of 39 degrees C, which subsided after the administration of a naturopathic herbal remedy. She developed jaundice 1 week before death, and her condition worsened on the day of death. Laboratory test results on admission showed a markedly elevated white blood cell count. Accordingly, the cause of death was suspected to be acute leukaemia. Forensic autopsy revealed the cause of death to be precursor B-cell ALL. With advancements in medical technology, the 5-year survival rate of children with ALL is nearly 90%. However, in this case, the deceased's parents preferred complementary and alternative medicine (i.e., naturopathy) to evidence-based medicine and had not taken her to a hospital for a medical check-up or immunisation since she was an infant. Thus, if she had received routine medical care, she would have a more than 60% chance of being alive 5 years after diagnosis. Therefore, we conclude that the parents should be accused of medical neglect regardless of their motives.
我们报告了一名2岁女童死于前驱B细胞急性淋巴细胞白血病(ALL)的病例,ALL是儿童中最常见的癌症。她没有明显的病史。她因呼吸窘迫被转诊至一家医院,并在抵达后4小时死亡。死亡前两周,她发烧至39摄氏度,服用一种自然疗法草药后体温下降。死亡前1周她出现黄疸,在死亡当天病情恶化。入院时的实验室检查结果显示白细胞计数显著升高。因此,怀疑死因是急性白血病。法医尸检显示死因是前驱B细胞ALL。随着医学技术的进步,ALL患儿的5年生存率接近90%。然而,在这个病例中,死者的父母更倾向于补充和替代医学(即自然疗法)而非循证医学,并且自她还是婴儿以来就没有带她去医院进行过体检或免疫接种。因此,如果她接受了常规医疗护理,她在诊断后5年存活的几率将超过60%。所以,我们得出结论,无论其动机如何,父母都应被指控医疗疏忽。