Leal Hernández Mariano, Navarro-Zaragoza Javier, Falcón María, Carrillo Navarro Francisco, Luna Aurelio
Área de Medicina Legal y Forense, Departamento de Ciencias Sociosanitarias, Universidad de Murcia.
Dpto. Farmacología. CP 30100, Facultad de Medicina, Universidad de Murcia.
Cuad Bioet. 2020 Sep-Dec;31(103):309-317. doi: 10.30444/CB.71.
Lately, number of divorces is increasing, nevertheless, a parents' divorce can become a traumatic problem for paediatric patients. Consequently, the aim of this study was to analyze the ethical conflicts that appear in the relationship between physician/parents/son/daughter, and more specifically those that a divorce generates. A descriptive study was developed through a survey composed by 39 items. Previously, an exhaustive bibliographic analysis was carried out. Our results show that only 35% of paediatricians interviewed have been educated in bioethics although this issue is important in daily practice. Other items show that 57,5% would not cancel a pharmacological treatment in order to improve quality of life. Also, they would react against a wrong parents' decision (82,5%). They give low value to the minor`s decision (6,05%), and rarely inform exclusively to adolescents (5%). In contrast, paediatricians sometimes ask to adolescents (20%) in first place and involved them to decide in 90% of cases. Besides, there are differences in the relation with fathers and mothers, 17,5% of mothers are informed exclusively, a fact that never happens with fathers. Ethics has an intrinsic value very important in daily clinical decisions in order to respect the rules and to adapt them to the situation of every paediatric patient. When an important ethical conflict become, as a divorce is, it is essential to know who must be informed and the rights everyone has to make a decision. It is complicated to the paediatricians yet to develop 41/2002 law for Patient's autonomy.
最近,离婚数量不断增加,然而,父母离婚对于儿科患者而言可能会成为一个造成精神创伤的问题。因此,本研究的目的是分析医生/父母/儿子/女儿关系中出现的伦理冲突,更具体地说是离婚所产生的伦理冲突。通过一项由39个项目组成的调查开展了一项描述性研究。此前,进行了详尽的文献分析。我们的结果显示,尽管生物伦理问题在日常实践中很重要,但仅有35%接受访谈的儿科医生接受过生物伦理学方面的教育。其他项目显示,57.5%的儿科医生不会为了提高生活质量而取消药物治疗。此外,他们会反对父母的错误决定(82.5%)。他们不太重视未成年人的决定(6.05%),而且很少只告知青少年(5%)。相比之下,儿科医生有时会首先询问青少年(20%),并在90%的情况下让他们参与决策。此外,与父亲和母亲的关系存在差异,只有17.5%的母亲会只被告知相关情况,而这种情况在父亲那里从未发生过。伦理在日常临床决策中具有非常重要的内在价值,以便遵守规则并使其适应每个儿科患者的情况。当出现像离婚这样重大的伦理冲突时,必须清楚该告知谁以及每个人做出决定的权利。对于儿科医生来说,要落实2002年第41号关于患者自主权的法律仍很困难。