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在临床和研究环境中获取知情同意的过程中儿童的道德构建。

Moral structuring of children during the process of obtaining informed consent in clinical and research settings.

作者信息

Díaz-Pérez Anderson, Navarro Quiroz Elkin, Aparicio Marenco Dilia Esther

机构信息

Department of Social and Human Sciences, Simón Bolívar University, Barranquilla, Colombia.

Corporación Universitaria Rafael Núñez, Faculty Of Health sciences, Cartagena de Indias, Colombia.

出版信息

BMC Med Ethics. 2020 Nov 25;21(1):122. doi: 10.1186/s12910-020-00540-z.

Abstract

BACKGROUND

Informed consent is an important factor in a child's moral structure from which different types of doctor-patient relationships arise. Children's autonomy is currently under discussion in terms of their decent treatment, beyond what doctors and researchers perceive. To describe the influential practices that exist among clinicians and researchers toward children with chronic diseases during the process of obtaining informed consent.

METHODS

This was a cross-sectional, qualitative study via a subjective and interpretivist approach. The study was performed by conducting semi-structured interviews of 21 clinicians and researchers. Data analysis was performed using the SPSS version 21® and Atlas Ti version 7.0® programs.

RESULTS

The deliberative and paternalistic models were influential practices in the physician-patient relationship. In the deliberative model, the child is expected to have a moral awareness of their care. The paternalistic model determined that submission was a way of structuring the child because he or she is considered to be a subject of extreme care.

CONCLUSIONS

The differentiated objectification [educational] process recognizes the internal and external elements of the child. Informed consent proved to be an appropriate means for strengthening moral and structuring the child.

摘要

背景

知情同意是儿童道德结构中的一个重要因素,由此产生了不同类型的医患关系。目前,儿童的自主权在其得到体面对待方面正受到讨论,这超出了医生和研究人员的认知范围。目的是描述临床医生和研究人员在获取知情同意过程中对慢性病儿童的影响性行为。

方法

这是一项采用主观解释主义方法的横断面定性研究。该研究通过对21名临床医生和研究人员进行半结构化访谈来开展。使用SPSS 21®版和Atlas Ti 7.0®版程序进行数据分析。

结果

协商模式和家长式模式是医患关系中的影响性行为。在协商模式中,期望儿童对自身的治疗具有道德意识。家长式模式则确定顺从是塑造儿童的一种方式,因为儿童被视为需要极度照料的对象。

结论

差异化的客观化[教育]过程认识到儿童的内在和外在因素。事实证明,知情同意是强化儿童道德和塑造儿童的恰当手段。

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本文引用的文献

1
Developing Autonomy and Transitional Paternalism.
Bioethics. 2016 Nov;30(9):759-766. doi: 10.1111/bioe.12280. Epub 2016 Sep 15.
2
Developing a new justification for assent.为同意制定新的理由。
BMC Med Ethics. 2016 Jan 12;17:2. doi: 10.1186/s12910-015-0085-x.
8
When a child's treatment decisions conflict with the parents'.当孩子的治疗决定与父母的决定相冲突时。
Home Healthc Nurse. 2005 Feb;23(2):123-6. doi: 10.1097/00004045-200502000-00023.

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