Paquette Erin
Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine, Division of Pediatric Critical Care, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois USA.
J Clin Ethics. 2019 Fall;30(3):218-222.
Children's age and developmental capacity leave them incapable of making medical decisions for themselves. Decisions for children are traditionally made under the best interest standard. Ross calls into question whether the best interest standard can function as both a guidance and intervention principle, able to be applied across the spectrum of pediatric decision making. Ross describes constrained parental autonomy as an alternative model, arguing that it affords parents the ability to make decisions within the context of their family while upholding a child's current and future interests. Although the model provides a robust framework for intrafamilial decision making, I question whether it can be broadly applied to children living in non-intimate families.
儿童的年龄和发育能力使他们无法为自己做出医疗决策。传统上，关于儿童的决策是依据最佳利益标准做出的。罗斯质疑最佳利益标准是否能够同时作为一种指导原则和干预原则，适用于儿科决策的各个方面。罗斯将受限的父母自主权描述为一种替代模式，认为它使父母能够在维护孩子当前和未来利益的同时，在家庭环境中做出决策。尽管该模式为家庭内部决策提供了一个有力的框架，但我质疑它是否能广泛适用于生活在非亲密家庭中的儿童。
