Paquette Erin Talati, Ross Lainie Friedman
Assistant Professor of Pediatrics, Division Critical Care Medicine, Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois USA.
Carolyn and Matthew Bucksbaum Professor of Clinical Ethics; Professor, Departments of Pediatrics, Medicine, and Surgery; Co-Director of the Institute for Translational Medicine and Associate Director of the MacLean Center for Clinical Medical Ethics, University of Chicago, Chicago, Illinois USA.
J Clin Ethics. 2020 Summer;31(2):121-125.
Decision making for children who suffer abusive head trauma invokes multiple ethical considerations. The degree to which parents are permitted to participate in decision making after the injury has occurred is controversial. In particular, in this issue of The Journal of Clinical Ethics, Grigorian and colleagues raise concerns about the potential for conflict of interest in end-of-life decision making if the parents are facing criminal charges that could be escalated if the child dies. There are additional concerns about the parents' capacity to make decisions that are best for the child, given that the injury occurred. We argue that there are important reasons not to exclude parents from the decision-making process and that, with appropriate safeguards in place, parents are integral to determining what is best for the child.
针对遭受虐待性头部创伤儿童的决策涉及多种伦理考量。受伤后允许父母参与决策的程度存在争议。特别是在本期《临床伦理学杂志》中，格里戈里安及其同事提出了担忧，如果父母面临刑事指控，而孩子死亡可能会使指控升级，那么在临终决策中就存在利益冲突的可能性。鉴于孩子已经受伤，对于父母做出最有利于孩子的决策的能力也存在其他担忧。我们认为，有重要理由不应将父母排除在决策过程之外，并且在有适当保障措施的情况下，父母对于确定什么对孩子最有利至关重要。
