Burns J P, Truog R D
Medical ICU, Children's Hospital, Boston, MA 02115, USA.
New Horiz. 1997 Feb;5(1):72-84.
Ethical dilemmas in clinical practice frequently center around who should make decisions for the patient, and what common principles can be used in making those decisions. In pediatrics, these dilemmas are complicated by balancing the interests of the child with the rights of parents and the responsibilities of clinicians. Other sources of controversy in caring for the pediatric population concern the confusion that continues around such issues as informed assent, the present standing of the "Baby Doe" regulations, and the forgoing of life-sustaining treatments. This article discusses the framework for decision-making in children that has evolved in ethics and the law over the last several decades.
临床实践中的伦理困境常常围绕着应由谁为患者做出决策,以及在做出这些决策时可以采用哪些共同原则。在儿科领域,这些困境因要平衡儿童的利益、父母的权利以及临床医生的责任而变得更加复杂。在照顾儿童群体方面,其他引发争议的问题包括围绕诸如知情同意、“宝贝 Doe”法规的现状以及放弃维持生命的治疗等问题持续存在的困惑。本文讨论了过去几十年来在伦理和法律方面逐渐形成的儿童决策框架。