Department of Pediatrics, ESIC Medical College and Hospital, NIT-3, Faridabad, Haryana, INDIA.
Indian J Med Ethics. 2024 Jul-Sep;IX(3):202-206. doi: 10.20529/IJME.2024.042.
Culturally competent healthcare improves patient satisfaction and clinical outcomes. Many drugs, dressings and implants have human or animal-derived content which may conflict with patients' religious beliefs, and may even have medicolegal implications.
This cross-sectional study (anonymous web-based survey) was done to understand the informed consent process followed by paediatricians and neonatologists in India, their views regarding disclosure pertaining to the animal origin of exogenous surfactants to patients' families, and their willingness and ability to provide alternative surfactants based on parental preferences.
A total of 114 neonatologists/paediatricians involved in neonatal care and using surfactants in their practice responded to the survey. Although 61(53.5%) neonatal care units stocked two or more brands of surfactant in their inventory, only 38(33.3%) units had both bovine and porcine preparations. Most (104, 91.2%) of the doctors always take parental consent before administering surfactants; but only a few (12,10.5%) said they always inform parents about its animal origin. None of the respondents offer parents a choice between bovine or porcine-origin surfactants, most (73, 64%) presuming that it would be irrelevant for the parents. However, many respondents (27, 23.7%) mentioned that they want to offer the choice to parents but are unable to do so because they do not stock both bovine and porcine preparations.
Although most parents might agree to a life-saving medicine in emergency situations, this does not mean they do not want to be informed. Healthcare professionals should not have a dismissive attitude to parental belief systems. They must use the antenatal period to take the cultural/spiritual history and the necessary consent.
文化能力强的医疗保健可以提高患者满意度和临床结果。许多药物、敷料和植入物都含有源自人类或动物的成分，这可能与患者的宗教信仰相冲突，甚至可能具有医学法律方面的影响。
这项横断面研究（匿名网络调查）旨在了解印度儿科医生和新生儿科医生遵循的知情同意程序，他们对向患者家属披露外源性表面活性剂的动物来源的看法，以及根据父母的偏好提供替代表面活性剂的意愿和能力。
共有 114 名参与新生儿护理并在实践中使用表面活性剂的新生儿科医生/儿科医生参与了这项调查。尽管 61 名（53.5%）新生儿护理单位在库存中储备了两种或更多品牌的表面活性剂，但只有 38 名（33.3%）单位有牛和猪制剂。大多数（104，91.2%）医生在使用表面活性剂前总是征得家长同意；但只有少数（12，10.5%）医生说他们总是告知家长其动物来源。没有一个受访者为家长提供牛源或猪源表面活性剂之间的选择，大多数（73，64%）认为这对家长来说无关紧要。然而，许多受访者（27，23.7%）提到他们希望为家长提供选择，但由于他们不储备牛和猪制剂，因此无法提供。
尽管大多数父母在紧急情况下可能会同意使用救命药物，但这并不意味着他们不想知情。医疗保健专业人员不应对父母的信仰体系持轻视态度。他们必须在产前期间了解文化/精神史并获得必要的同意。
