Koshy Anson J, Sisti Dominic A
Department of Pediatrics, Children's Learning Institute, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
Department of Medical Ethics & Health Policy, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
J Med Ethics. 2015 Dec;41(12):977-81. doi: 10.1136/medethics-2014-102166. Epub 2015 Jun 25.
The American Academy of Paediatrics endorses obtaining assent when prescribing medications for attention-deficit/hyperactivity disorder (ADHD) in older children whenever possible. Studies indicate the concept of assent may not be well understood by clinicians, possibly effecting effective and widespread implementation. We argue that though the concept of assent continues to evolve, it is critical in the context of patient-centred care, shared decision-making and in supporting minors' transition to adulthood. Based on the principle of respect for young persons, we argue that obtaining assent is an ethical imperative when prescribing medication for ADHD. We highlight the instrumental benefits of obtaining assent in the paediatric clinical encounter when prescribing medications for treatment of ADHD.
美国儿科学会支持在为大龄儿童开具治疗注意力缺陷多动障碍(ADHD)的药物时尽可能征得其同意。研究表明,临床医生可能并未充分理解同意这一概念,这可能会影响该做法的有效及广泛实施。我们认为,尽管同意这一概念仍在不断发展,但在以患者为中心的医疗、共同决策以及支持未成年人向成年人过渡的背景下,它至关重要。基于尊重年轻人的原则,我们认为在为ADHD开具药物时征得同意是一项道德要求。我们强调在儿科临床诊疗过程中为治疗ADHD开具药物时征得同意所带来的实际益处。