在青少年时期,同意的能力与拒绝治疗和程序的能力不同吗?
Is the capacity to consent different from the capacity to refuse treatments and procedures in adolescence?
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 Jul-Aug;101(4):501-510. doi: 10.1016/j.jped.2025.04.004. Epub 2025 May 15.
OBJECTIVE
The objective of this article is to broaden the discussion on the factors that constitute adolescent healthcare decisional capacity, ensuring that adolescents are recognized as capable of refusing treatments or procedures.
SOURCES
Materials from different sources were analyzed, including articles from reputable databases and documents from government agencies, forming a purposefully selected sample. The research was conducted in two phases: document selection and reflective analysis, followed by a report. The discussion was approached from a phenomenological perspective, with reflections grounded in human rights principles.
SUMMARY OF THE FINDINGS
Healthcare decisional capacity must be sufficiently robust to allow adolescents to refuse treatments or procedures. It is essential to respect the right of capable adolescents to refuse treatments and procedures. Protecting the vulnerability of adolescent patients involves honoring their growing autonomy. Data from field research regarding the refusal of treatments and procedures in adolescence are scarce, which limits the scope of the proposed discussion.
CONCLUSIONS
It cannot be argued that adolescents should have different abilities to refuse a treatment or procedure compared to those required to give consent. The importance of these skills seems to vary between these situations. This difference is justified by the need to consider potential harm to health, even though it could be argued that damage to health should be part of the bioethical deliberation surrounding the decision, rather than a factor in the assessment of decisional capacity.
目的
本文旨在拓宽对构成青少年医疗决策能力的因素的讨论,确保青少年被认可有能力拒绝治疗或程序。
资料来源
分析了来自不同来源的材料,包括知名数据库的文章和政府机构的文件,形成了一个有目的选择的样本。研究分两个阶段进行:文件选择和反思性分析,随后形成报告。讨论从现象学角度展开,反思基于人权原则。
研究结果总结
医疗决策能力必须足够强大,以使青少年能够拒绝治疗或程序。尊重有能力的青少年拒绝治疗和程序的权利至关重要。保护青少年患者的脆弱性涉及尊重他们日益增长的自主性。关于青少年拒绝治疗和程序的实地研究数据稀少,这限制了所提议讨论的范围。
结论
不能认为青少年拒绝治疗或程序的能力与同意治疗或程序所需的能力不同。这些技能的重要性在这些情况之间似乎有所不同。这种差异是合理的,因为需要考虑对健康的潜在危害,尽管可以认为健康损害应成为围绕该决定的生物伦理审议的一部分,而不是评估决策能力的一个因素。