Bross D C
Child Abuse Negl. 1982;6(4):375-81. doi: 10.1016/0145-2134(82)90080-1.
Discussed in sequence in this article are: the information which must pass from doctors to patients in the United States before a medical procedure is legally authorized, the necessity for comparable information to be provided to a judge who is being asked to order medical treatment for a child over objections by parents, the factors likely to influence a judge to order treatment over parental objections, and a process for deciding when the threshold for court intervention has been reached. While the general right of parents to be informed sufficiently and then to give consent for medical procedures, or to refuse to give consent, on behalf of their children is not in question, judges to override parental refusals to agree to care which is lifesaving or prevents severe impairment. An analysis of American law reveals that the factors likely to support court orders for treatment are: sufficient data has been provided for full, informed consent; a very severe prognosis exists if treatment is not provided, for example, death, retardation, paralysis, or blindness; delay is not a reasonable alternative; the medical procedure is not experimental and is likely to succeed; there are few contraindications; the quality of the child's life, given a successful intervention, will be at least of average "quality"; a child who is older consents to the procedure; and there is no strongly conflicting medical opinion. After a thorough discussion of medical factors with parents, court intervention should be considered if it is thought by those involved that no minimally reasonable parent would refuse to consent to treatment under the circumstances.
在美国,在医疗程序获得合法授权之前,医生必须向患者传达的信息;当法官被要求不顾父母反对为儿童下令进行医疗治疗时,向其提供可比信息的必要性;可能影响法官不顾父母反对下令进行治疗的因素;以及确定何时达到法院干预门槛的程序。虽然父母有充分知情权并代表子女同意或拒绝医疗程序的一般权利没有问题,但法官有权推翻父母拒绝同意挽救生命或防止严重损伤的治疗。对美国法律的分析表明,可能支持法院下达治疗令的因素包括:已提供足够数据以获得充分的知情同意;如果不进行治疗,预后非常严重,例如死亡、智力迟钝、瘫痪或失明;拖延不是合理的选择;医疗程序不是实验性的且可能成功;禁忌症很少;如果干预成功,孩子的生活质量至少将达到平均“水平”;年龄较大的孩子同意该程序;并且没有强烈冲突的医学意见。在与父母充分讨论医疗因素后,如果相关人员认为在这种情况下没有最低限度合理的父母会拒绝同意治疗,则应考虑法院干预。