Acting instructor and senior clinical fellow in pediatric bioethics and palliative care at the University of Washington School of Medicine in Seattle.
Associate professor in the Department of Pediatrics' Division of Hematology-Oncology at the University of Washington School of Medicine in Seattle.
AMA J Ethics. 2020 May 1;22(5):E372-379. doi: 10.1001/amajethics.2020.372.
Shared decision making (SDM) is used in adult and pediatric practice for both its ethical and its practical benefits. However, its use is complicated with adolescents whose emerging and relational autonomy is distinct from that of adults, who make decisions independently, and children, whose parents make decisions for them. This hypothetical case scenario and commentary provide clinicians with a practical and stepwise approach to SDM with adolescents as well as guidance when SDM breaks down.
共享决策（SDM）在成人和儿科实践中都因其伦理和实际效益而被使用。然而，对于青少年来说，SDM 的使用比较复杂，因为他们的自主性正在发展且与成人不同，后者独立做出决策，而儿童则由父母为他们做出决策。这个假设的案例情景和评论为临床医生提供了一种实用的、逐步的方法，用于与青少年进行 SDM，并在 SDM 失败时提供指导。
