Johnson Liza-Marie, Church Christopher L, Metzger Monika, Baker Justin N
a St. Jude Children's Research Hospital.
Am J Bioeth. 2015;15(5):3-17. doi: 10.1080/15265161.2015.1021965.
There is little information about the content of ethics consultations (EC) in pediatrics. We sought to describe the reasons for consultation and ethical principles addressed during EC in pediatrics through retrospective review and directed content analysis of EC records (2000-2011) at St. Jude Children's Research Hospital. Patient-based EC were highly complex and often involved evaluation of parental decision making, particularly consideration of the risks and benefits of a proposed medical intervention, and the physician's fiduciary responsibility to the patient. Nonpatient consultations provided guidance in the development of institutional policies that would broadly affect patients and families. This is one of the few existing reviews of the content of pediatric EC and indicates that the distribution of ethical issues and reasons for moral distress are different than with adults. Pediatric EC often facilitates complex decision making among multiple stakeholders, and further prospective research is needed on the role of ethics consultation in pediatrics.
关于儿科伦理咨询（EC）的内容，现有信息较少。我们试图通过回顾性审查以及对圣犹大儿童研究医院2000年至2011年的伦理咨询记录进行定向内容分析，来描述儿科伦理咨询的咨询原因及涉及的伦理原则。基于患者的伦理咨询非常复杂，常常涉及对家长决策的评估，尤其是对拟议医疗干预措施的风险和益处的考量，以及医生对患者的信托责任。非患者咨询为制定会广泛影响患者和家庭的机构政策提供了指导。这是为数不多的对儿科伦理咨询内容的现有综述之一，表明伦理问题的分布及道德困扰的原因与成人不同。儿科伦理咨询常常有助于多个利益相关方之间进行复杂的决策，关于伦理咨询在儿科中的作用，还需要进一步的前瞻性研究。
