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青少年在临床环境中的医疗决策能力:一项理论研究与模型

Adolescents' healthcare decisional capacity in the clinical context: a theoretical study and model.

作者信息

Martins Guilherme Henrique, Eler Kalline, Albuquerque Aline, Nunes Rui

机构信息

Faculty of Medicine, University of Porto, Porto, Portugal.

Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil.

出版信息

J Pediatr (Rio J). 2025 Mar-Apr;101(2):150-157. doi: 10.1016/j.jped.2024.08.004. Epub 2024 Sep 5.

Abstract

OBJECTIVE

To provide a theoretical study and model for the bioethical foundations of the factors that influence adolescents' healthcare decisional capacity.

SOURCES

Materials from diverse sources, including indexed articles in recognized databases and official government documents, were examined for a purposefully selected sample. The research consisted of two stages: selection of documents and reflective thematic analysis, followed by the preparation of a report. The analysis adopted a phenomenological stance and a reflective view compatible with human rights. To reduce bias and ensure the robustness of the results, measures such as data triangulation were employed. Ethical measures were taken to ensure data integrity, including considerations of anonymity and conflicts of interest in the selected studies.

SUMMARY OF THE FINDINGS

It was possible to list intrinsic and extrinsic factors of the adolescent patient that influence their decisional capacity regarding health. A theoretical model was developed to discuss these factors for evaluation by means of an infographic.

CONCLUSIONS

It seems clear that the evaluation of healthcare decisional capacity of adolescents must position itself ethically regarding the tension between the moral duty to respect the self-determination of the able subject and the need to protect adolescents decidedly unable to make a specific health decision at a given time.

摘要

目的

为影响青少年医疗决策能力的因素的生物伦理基础提供理论研究和模型。

资料来源

对来自不同来源的材料进行了审查,包括公认数据库中的索引文章和官方政府文件,以获取有目的选择的样本。该研究包括两个阶段:文件选择和反思性主题分析,随后编写报告。分析采用了现象学立场和与人权相符的反思观点。为减少偏差并确保结果的稳健性,采用了数据三角测量等措施。采取了伦理措施以确保数据完整性,包括在所选研究中考虑匿名性和利益冲突。

研究结果总结

可以列出影响青少年患者健康决策能力的内在和外在因素。开发了一个理论模型,通过信息图来讨论这些因素以供评估。

结论

显然,对青少年医疗决策能力的评估必须在道德上定位自身,以应对尊重有能力主体的自决权的道德义务与保护在特定时间明显无法做出特定健康决策的青少年的需求之间的紧张关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98c6/11889686/5762b0eb3000/gr1.jpg

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