最佳利益和低门槛：与瑞典未满 18 岁人群的针具和注射器服务相关的法律和伦理问题。
Best interests and low thresholds: legal and ethical issues relating to needle and syringe services for under 18s in Sweden.
机构信息
School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Social Work, University of Gothenburg, Gothenburg, Sweden.
出版信息
Harm Reduct J. 2022 Feb 11;19(1):15. doi: 10.1186/s12954-022-00597-6.
Access for legal minors to needle and syringe programmes raises a number of practical, legal and ethical challenges that traverse clinical practice, child protection and child rights. This article addresses the current legal age restriction on access to needle and syringe programmes (NSPs) in Sweden. Based on legislation and legislative preparatory works, it traces the rationale for retaining an age restriction in the context of a policy priority to improve access for people who inject drugs. Building on threshold theory and child rights literature, the article unpacks the apparent tension between protecting the low threshold nature of service provision, child protection duties of healthcare staff, and the best interests of the child. It explores whether this tension could be alleviated through replacing a legal age restriction for all with best interests assessments for each individual, and discusses the potential ethical and practical challenges involved in such a change.
未成年者获得针具交换项目（NSP）存在一系列实际、法律和伦理挑战，这些挑战贯穿临床实践、儿童保护和儿童权利。本文探讨了瑞典现行的针具交换项目准入年龄限制。基于立法和立法准备工作，本文追溯了在优先提高注射毒品者准入的政策背景下保留年龄限制的基本原理。本文借鉴门槛理论和儿童权利文献，剖析了在保护服务提供的低门槛性质、医疗保健人员的儿童保护职责以及儿童最佳利益之间明显存在的紧张关系。本文探讨了是否可以通过用对每个个体的最佳利益评估取代对所有人的法律年龄限制来缓解这种紧张关系，并讨论了这种改变所涉及的潜在伦理和实际挑战。
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