儿科死亡相关的伦理问题：在涉及维持生命的医疗治疗时，关于同意、同意表示和意见分歧的处理。

Ethical Issues Around Pediatric Death: Navigating Consent, Assent, and Disagreement Regarding Life-Sustaining Medical Treatment.

机构信息

Division of General Pediatrics and Adolescent Medicine, The Johns Hopkins Hospital, Johns Hopkins University Berman Institute of Bioethics, 200 North Wolfe Street, Baltimore, MD 21287, USA.

Division of Pediatric Hematology/Oncology, The Herman and Walter Samuelson Children's Hospital at Sinai, 2401 West Belvedere Avenue, Baltimore, MD 21215, USA; Johns Hopkins University Berman Institute of Bioethics, 1809 Ashland Avenue, Baltimore, MD 21205, USA.

出版信息

Child Adolesc Psychiatr Clin N Am. 2018 Oct;27(4):539-550. doi: 10.1016/j.chc.2018.05.009. Epub 2018 Jul 25.

DOI:10.1016/j.chc.2018.05.009

PMID:30219216

Abstract

Decisions regarding whether or not to pursue experimental therapies or life-sustaining medical treatment of children with life-limiting illness can be a significant source of distress and conflict for both families and health care providers. This article reviews the concepts of parental permission (consent), assent, and emerging capacity and how they relate to decision-making for minors with serious illness. Decision-making capacity for adolescents is discussed generally and in the context of emotionally charged situations pertaining to the end of life. Strategies for minimizing conflict in situations of disagreement between children and families are provided.

摘要

关于是否寻求对患有危及生命疾病的儿童进行实验性治疗或维持生命的医疗治疗的决定，可能会给家庭和医疗保健提供者带来重大的痛苦和冲突。本文回顾了父母同意（同意）、同意和新兴能力的概念，以及它们与重病未成年人决策的关系。一般讨论了青少年的决策能力，并讨论了与生命末期有关的情绪激动情况下的决策能力。提供了在儿童和家庭之间存在分歧的情况下减少冲突的策略。