Fedeli Piergiorgio, Giorgetti Sergio, Cannovo Nunzia
School of Law, Legal Medicine Section, University of Camerino (MC), Camerino, Italy.
Hospital of San Severino Marche, AV3- Asur Marche, Macerata, Italy.
Open Med (Wars). 2020 Jun 8;15(1):513-519. doi: 10.1515/med-2020-0152. eCollection 2020.
In Italy, both parents have parental responsibility, so they have the power to give or withhold consent to medical procedures on their children.
The present work reports the case of a 5-year-old boy diagnosed with neuroblastoma in the right adrenal loggia, who underwent several chemotherapy treatments that prolonged his life until the age of 10. Informed consent for treatments was requested exclusively of the parents, without taking into consideration the minor's will, not even when he asked for increased pain relief medication instead of other palliative treatments.
The authors thought it interesting to examine the case in the light of new Italian legislation on informed consent and to verify whether it promotes greater participation of minors in healthcare choices, given that the issue of acquisition of informed consent is becoming increasingly broad and complex.
The case examined here indicates that current Italian legislation, even including the modifications introduced, does not allow for concrete and active participation of minors, especially those under the age of 12, in the discussion of choices about their health, not even in choices regarding the end of life, and not even when the minor manifests a mature capacity for discernment.
在意大利,父母双方都有亲权,因此他们有权对子女的医疗程序给予或拒绝同意。
本研究报告了一名5岁男孩的病例,该男孩被诊断出右肾上腺腔患有神经母细胞瘤,他接受了多次化疗,这些治疗延长了他的生命直至10岁。治疗的知情同意仅向父母征求,未考虑未成年人的意愿,即使他要求增加止痛药物而非其他姑息治疗时也是如此。
鉴于获取知情同意的问题日益广泛和复杂,作者认为根据意大利关于知情同意的新立法来审视该病例,并验证其是否促进未成年人更多地参与医疗保健选择是很有意思的。
此处所研究的病例表明,现行意大利法律,即使包括引入的修改内容,也不允许未成年人,尤其是12岁以下的未成年人切实、积极地参与关于其健康选择的讨论,甚至在关于生命终结的选择方面也不行,即便未成年人表现出成熟的辨别能力时也是如此。