Division of Hematology and Oncology, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri.
Division of Psychology, Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee.
Pediatr Blood Cancer. 2019 May;66(5):e27608. doi: 10.1002/pbc.27608. Epub 2019 Jan 8.
The diagnosis and treatment of cancer leads to short-term and long-term challenges for every patient. This is especially true for adolescents and young adults (AYAs) with cancer who strive to gain independence, autonomy, confidence, and social status while developing into adulthood. In this article, we review prominent ethical issues in AYA oncology that are related to autonomy, shared decision-making, care refusal or abandonment, end-of-life care, truth telling, and fertility preservation. Clinicians should recognize that AYA patients develop at their own pace; the onus lies with clinicians to determine the patient's interests, values, maturity, and desire to participate in decision-making.
癌症的诊断和治疗给每个患者带来了短期和长期的挑战。对于患有癌症的青少年和年轻成年人（AYA）来说尤其如此，他们在成长为成年人的过程中努力获得独立、自主、自信和社会地位。在本文中，我们回顾了与 AYA 肿瘤学相关的自主、共同决策、拒绝或放弃治疗、临终关怀、说实话和生育力保存等突出的伦理问题。临床医生应该认识到，AYA 患者的发展速度各不相同；临床医生有责任确定患者的利益、价值观、成熟度和参与决策的意愿。
