Advance directives by children and parents - Advance care planning in pediatrics
Advance directives by children and parents - Advance care planning in pediatrics
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DOI：
10.1007/s00112-008-1857-x
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发表时间：
2009-01-01
影响因子：
0.4
通讯作者：
Borasio, G. D.
中科院分区：
文献类型：
--
作者：
Jox, R. J.;Fuehrer, M.;Borasio, G. D.
在成人医学和儿科，预先指示（AD）的患病率和重要性都在增加。然而，它们在儿科中的作用几乎从未得到重视。有能力的儿童或青少年的AD与父母的AD有明显的区别。前者类似于成年患者的AD，问题在于能力的界定和评估。父母的诉讼是基于宪法赋予父母代表孩子做决定的权利。然而，这一权利受到儿童福祉的限制，而儿童福祉是由社会普遍接受的价值观预先确定的。因此，父母的广告与其说是一种对抗，不如说是一种沟通的工具。这两种形式的预期决策都应成为以早期和公开沟通为特征的预先护理规划过程的一部分。
The prevalence and significance of advance directives (AD) is increasing both in adult medicine and pediatrics. Yet their role in pediatrics has almost never been addressed. There is a sharp difference between the AD of a competent child or adolescent and the AD of parents. The former is analogous to the AD of adult patients, and the problem lies in defining and assessing competence. The AD of parents is grounded in the constitutional right of parents to decide on behalf of their children. This right is, however, limited by the child's wellbeing, which is predefined by generally accepted values in society. For this reason, the AD of parents is more an instrument of communication than of confrontation. Both forms of anticipatory decision making should be part of an advance care planning process that is characterized by early and open communication.