儿科医学关注的视野:在儿童被遗弃、冲突、伤害或危险的情况下与严重疾病相结合的情况下该怎么做?

Jéssica H. Guadarrama-Orozco, G. Cantú-Quintanilla, D. Avila-Montiel, Myriam M. Altamirano‐Bustamante, I. Peláez-Ballestas, Cristina Caballero-Velarde, L. Juárez-Villegas, Nahúm de la Vega-Morell, J. Kelly-García, Adalberto de Hoyos-Bermea, E. Dorantes-Acosta, J. Gamboa-Marrufo, O. Muñoz-Hernández, J. Garduño-Espinosa
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引用次数: 0

摘要

背景:法律规定,未成年人没有能力对自己的医疗护理作出知情同意。但是,在一些特殊条件下,他们可以决定自己的健康状况。对未成年人的判断和经验限制越大,就越不重视他们所表达的价值观和目标。此外,可能产生的不利后果越多,代表未成年人作出决定所需要的权力就越高,从而使国家有能力保障未成年人的福祉。病例报告:12岁女患者,诊断为急性淋巴细胞白血病,社会家庭背景不稳定;由于她不卫生和极端贫困的条件,无视治疗,阻碍了疾病的发展。她的父母在开始治疗后不久就去世了,她由达到法定年龄的同父异母妹妹照顾。墨西哥儿童医院Federico Gomez的儿科医生和工作人员的工作和道德困境暴露在支持网络的建设中,其目标是优先考虑未成年人的福祉,不允许家庭破裂或解体,从而成功地恢复她的健康。结论:该病例已提交医院生命伦理委员会。机构间支助网络的建立是为了改善家庭的活力,从而解决未成年人的需要。尽管情况很不幸,但疾病还是被成功地克服了。
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The horizon of medical attention in pediatrics: What to do in the case of children who are in abandonment, conflict, harm, or danger situations in combination with a severe disease?
Background:Laws refer that minors do not have the capability to give informed consent for their own medical attention. However, there are special conditions in which they are allowed to decide about their health. The greater the judgement and experience limitations in minors, the less weight is given to the values and objectives they express. Also, the more adverse consequences might be, the higher the level of authority that is demanded to decide on behalf of the minor, thus granting the State the capability to guarantee the well-being of the minor. Case report:12-year-old female patient with a diagnosis of acute lymphoblastic leukemia, with precarious social and family background; evolution of the disease obstructed by the disregard of the treatment due to her unsanitary and extreme poverty conditions. Both of her parents died soon after the start of the treatment and she was kept under the care of her half-sister of legal age. The work and the ethical dilemma of the pediatrician and the staff of Hospital Infantil de Mexico Federico Gomez are exposed within the building of support -networks with the objective of prioritizing the minor's well-being, without allowing family break-up or disintegration, thus succeeding in her recovery. Conclusions:The case was submitted to the Hospital Bioethics Committee. Inter-institutional support networks were built in order to improve dynamics of the family, thus solving the needs of the minor. Despite the misfortune of the situation, the disease was successfully overcome.
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