Coughlin Kevin W
Canadian Paediatric Society, Bioethics Committee, Ottawa, Ontario.
Paediatr Child Health. 2018 May;23(2):138-146. doi: 10.1093/pch/pxx127. Epub 2018 Apr 12.
Medical decision-making in the paediatric population is complicated by the wide variation in physical and psychological development that occurs as children progress from infancy to adolescence. Parents and legal guardians are the de facto decision-makers in early infancy, but thereafter, the roles of parents/legal guardians and paediatric patients become ever more complex. Health care providers (HCPs), while not decision-makers per se, have a significant role in medical decision-making throughout childhood. This statement outlines the ethical principles of medical decision-making for HCPs involved in caring for paediatric patients. This revision focuses on individual decision-making in the context of the patient-provider relationship and provides increased guidance for dealing with disagreements.
儿童从婴儿期到青春期，身体和心理发育存在广泛差异，这使得儿科医疗决策变得复杂。在婴儿早期，父母和法定监护人实际上是决策者，但此后，父母/法定监护人和儿科患者的角色变得越来越复杂。医疗保健提供者（HCPs）本身虽不是决策者，但在儿童期的医疗决策中发挥着重要作用。本声明概述了参与儿科患者护理的HCPs医疗决策的伦理原则。本次修订重点关注医患关系背景下的个体决策，并为处理分歧提供了更多指导。
