Ciliberti Rosagemma, Alfano Linda, Baldelli Ilaria, De Stefano Francesco, Bonsignore Alessandro
University of Genova, Italy.
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Acta Biomed. 2018 Feb 28;89(1):34-40. doi: 10.23750/abm.v89i1.6368.
The social role of the minor, as indeed that of the physician, has changed markedly. This transformation has given rise to new patterns and responsibilities in the management of healthcare procedures that involve minors.
According to international legislation, in the clinical setting, as in other areas of social life, minors have the right to be heard and to have their opinions taken into consideration as an increasingly determining factor, in accordance with their age and degree of maturity and discernment. The authors describe the right to information and the decision-making process when the patient is a minor and underline the role of the parties involved (physicians, parents, under-age patient, judge) in various circumstances. Specifically, the paper analyzes the ethical and legal issues relating to the entitlement to decisions concerning the medical treatment of children and assesses the importance that Italian law attaches to the will of minors in the healthcare choices that affect them.
Healthcare workers are called upon to face new challenges in order to ensure that healthcare services are able to safeguard the interests of minors while, at the same time, respecting their will. How to evaluate children's competence to consent and how to balance the autonomy of parents and minors are crucial questions which the law courts in the various countries are increasingly being asked to address. These issues require close collaboration among various figures (parents, doctors, psychologists, judges) and imply the ethical need to undergo continuous training.
未成年人的社会角色，实际上与医生的角色一样，已经发生了显著变化。这种转变在涉及未成年人的医疗程序管理中产生了新的模式和责任。
根据国际立法，在临床环境中，与社会生活的其他领域一样，未成年人有权被倾听，并根据其年龄、成熟程度和辨别力，使他们的意见作为一个越来越具决定性的因素得到考虑。作者描述了患者为未成年人时的知情权和决策过程，并强调了各方（医生、父母、未成年患者、法官）在各种情况下的作用。具体而言，本文分析了与儿童医疗治疗决策权利相关的伦理和法律问题，并评估了意大利法律在影响未成年人的医疗选择中对其意愿的重视程度。
医疗工作者面临着新的挑战，以确保医疗服务能够在维护未成年人利益的同时，尊重他们的意愿。如何评估儿童的同意能力，以及如何平衡父母和未成年人的自主权，是各国法院越来越多地被要求解决的关键问题。这些问题需要各方（父母、医生、心理学家、法官）密切合作，并意味着在伦理上需要接受持续培训。
