Dreisinger Naomi, Zapolsky Nathan
Pediatr Emerg Care. 2018 Apr;34(4):288-290. doi: 10.1097/PEC.0000000000001131.
Informed consent is a communicative process of sharing information with patients, which helps assure their understanding of the information provided and asks for their permission to proceed. Informed consent allows a patient or a patient's family to use his or her own value system to determine the need for a particular procedure or test. Asking a patient for permission to treat requires the provider to respect the patient's autonomy through allowing him or her to be an active part of the decision-making process. Consent in the pediatric emergency department can be a complex process. Parental consent is generally required for medical evaluation and treatment of pediatric patients, but in the pediatric emergency department, there are exceptions to this rule. If the provider determines that a parent's refusal of consent places the child at risk of harm, then consent is not necessary. By using the concepts of Emergency Medical Treatment and Active Labor Act, in emergent situations, consent may not be necessary. Finally, adolescents are often deeply concerned about privacy-their acceptance of appropriate care is often based on this promise of confidentiality. In the emergency department, adolescents can therefore be treated for issues relating to reproductive care without parental consent. It is important for the emergency department physician to understand the rules surrounding the care of pediatric patients to avoid compromising their privacy and ultimately their well-being and medical care.
知情同意是一个与患者分享信息的交流过程，有助于确保他们理解所提供的信息，并请求他们允许继续进行。知情同意使患者或患者家属能够利用自己的价值体系来决定是否需要进行特定的程序或检查。请求患者允许治疗要求医疗服务提供者通过让患者成为决策过程的积极参与者来尊重患者的自主权。在儿科急诊科，同意可能是一个复杂的过程。儿科患者的医疗评估和治疗通常需要父母同意，但在儿科急诊科，这条规则有例外情况。如果医疗服务提供者确定父母拒绝同意会使孩子面临伤害风险，那么同意就不是必需的。根据《紧急医疗救治与分娩法案》的概念，在紧急情况下，可能不需要同意。最后，青少年通常非常关注隐私——他们接受适当治疗往往基于这种保密承诺。因此，在急诊科，青少年可以在未经父母同意的情况下接受与生殖保健相关问题的治疗。急诊科医生了解围绕儿科患者护理的规则很重要，以避免侵犯他们的隐私，最终损害他们的福祉和医疗护理。
