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对儿童和成人烧伤患者采取不同的疼痛治疗方式是否符合伦理道德?

Is It Ethical to Treat Pain Differently in Children and Adults with Burns?

作者信息

Dissanaike Sharmila

机构信息

A burn and trauma surgeon and the Peter C. Canizaro Chair of the Department of Surgery at Texas Tech University Health Sciences Center in Lubbock, Texas, and the chair of the American Burn Association Ethical Issues Committee and is a member of the American College of Surgeons Committee on Ethics.

出版信息

AMA J Ethics. 2018 Jun 1;20(6):531-536. doi: 10.1001/journalofethics.2018.20.6.cscm1-1806.

Abstract

This commentary discusses ethical implications of the common practice of treating children's and adults' burn pain differently. Physicians have obligations to ensure that (1) their own discomfort with children's pain doesn't lead them to make pain management decisions that could place a patient at greater risk and (2) to engage in thoughtful, individualized pain management strategies. Long-term consequences of overzealous pain medication administration, for example, could include delayed recovery and integration or opioid dependence. The need to create individualized approaches to pain management, based on published guidelines, is discussed along with uses of nonpharmacological treatment for both adults and children.

摘要

本评论讨论了对儿童和成人烧伤疼痛采取不同治疗方法这一常见做法的伦理影响。医生有义务确保:(1)他们自身对儿童疼痛的不适感不会导致他们做出可能使患者面临更大风险的疼痛管理决策;(2)采用深思熟虑的、个性化的疼痛管理策略。例如,过度积极地使用止痛药物的长期后果可能包括恢复和康复延迟或阿片类药物依赖。文中讨论了根据已发表的指南制定个性化疼痛管理方法的必要性,以及成人和儿童非药物治疗的应用。

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