Sigman G S, Kraut J, La Puma J
Center for Clinical Ethics, Lutheran General Hospital, Park Ridge, IL 60068.
Am J Dis Child. 1993 Jul;147(7):764-8. doi: 10.1001/archpedi.1993.02160310066020.
Parents of children and adolescents occasionally request nondisclosure of a diagnosis to the patient. This ethical dilemma was analyzed using a case in which parents of a child with cystic fibrosis demanded that the physician not reveal the diagnosis to their daughter. The case study helps to identify the specific clinical factors that may be considered when confronting similar dilemmas in other cases. Any justification for lying to the patient or hiding information must derive from clinical circumstances that override the basic moral duty to tell the truth. The physician, the disease, the patient, and the family are all pertinent to the ethical decision of disclosure. These factors may change over time with the natural history of the disease and the maturation of the patient.
儿童和青少年的家长偶尔会要求对患者隐瞒诊断结果。通过一个案例分析了这一伦理困境，案例中一名囊性纤维化患儿的家长要求医生不对他们的女儿透露诊断结果。该案例研究有助于确定在其他案例中遇到类似困境时可能需要考虑的具体临床因素。任何对患者说谎或隐瞒信息的理由都必须源自于高于讲真话这一基本道德义务的临床情况。医生、疾病、患者和家庭都与信息披露的伦理决策相关。随着疾病的自然发展过程和患者的成熟，这些因素可能会随时间而变化。
