Ross Lainie Friedman
University of Chicago Departments of Pediatrics, Medicine, Surgery and the College; MacLean Center for Clinical Medical Ethics, Chicago, IL USA.
J Clin Ethics. 2020 Winter;31(4):331-337.
In this issue of The Journal of Clinical Ethics, Professor Ruth Tallman argues that pediatricians ought to support adolescent football players in their athletic goals. She does not deny that doing so means "helping children hurt themselves"; rather she argues that this would be consistent with a shared decision-making model in which both the physician and the patient seek to promote the patient's well-being in light of the patient's own goals. I argue that this ignores the role of the parents, meaning that Tallman is suggesting "helping parents allow their children to hurt themselves." As a general pediatrician, I would classify this as child neglect, if not downright child abuse. I argue that pediatricians should counsel directively against youth tackle football, employ a deliberative approach to shared decision making within the triadic doctor-patient-parent relationship, and support youth sport policies that seek to reduce traumatic brain injury by advocating for flag football, by prohibiting checking in boys' ice hockey, and by minimizing heading the ball in soccer below a certain age.
在本期《临床伦理学杂志》中，露丝·塔尔曼教授认为儿科医生应该支持青少年橄榄球运动员实现他们的运动目标。她并不否认这样做意味着“帮助孩子伤害自己”；相反，她认为这将符合一种共同决策模式，在这种模式中，医生和患者都根据患者自己的目标来寻求促进患者的福祉。我认为这忽视了父母的角色，这意味着塔尔曼在建议“帮助父母允许他们的孩子伤害自己”。作为一名普通儿科医生，如果这不算彻头彻尾的虐待儿童，我会将其归类为忽视儿童。我认为儿科医生应该直接建议反对青少年橄榄球运动，在医患家长三方关系中采用协商的方式进行共同决策，并支持旨在通过提倡旗帜橄榄球、禁止男子冰球中的身体冲撞以及在足球运动中在一定年龄以下尽量减少头球来减少创伤性脑损伤的青少年体育政策。
