Three decades after Baby Doe: how neonatologists and bioethicists conceptualize the Best Interests Standard
Three decades after Baby Doe: how neonatologists and bioethicists conceptualize the Best Interests Standard
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DOI：
10.1038/jp.2016.87
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发表时间：
2016-10-01
影响因子：
2.9
通讯作者：
McCullough, L. B.
中科院分区：
文献类型：
--
作者：
Placencia, F. X.;Ahmadi, Y.;McCullough, L. B.
目的：本研究的目的是要确定产科医生和生物伦理学家如何概念化和应用最佳利益标准（BIS）。研究设计：美国生物伦理学与人文学会和美国儿科学会新生儿-围产期医学科的成员进行了调查，以确定他们如何概念化BIS，并对放弃生命维持治疗（LST）的适当性进行排名。新生儿医生的中位数反应支持婴儿特定的BIS概念化，将婴儿和家庭的利益联系起来。他们不支持对家庭义务加以限制。伦理学家支持一种概念化，将婴儿和家庭的利益与家庭义务的限制联系起来，这是一种不太针对婴儿的概念化。伦理学家较少或同样可能同意放弃LST在七个cases.CONCLUSIONS：伦理学家赞同的概念化的BIS，包括对家庭的影响，并拒绝了一个婴儿特定的。新生儿学家在这两者之间分裂，拒绝限制家庭的义务。新生儿伦理学需要对BIS进行严格的评估。
OBJECTIVE: The objective of this study is to determine how neonatologists and bioethicists conceptualize and apply the Best Interests Standard (BIS).STUDY DESIGN: Members of the American Society for Bioethics and Humanities and the American Academy of Pediatrics Section on Neonatal-Perinatal Medicine were surveyed to determine how they conceptualized the BIS and ranked the appropriateness of forgoing life-sustaining therapy (LST).RESULTS: Neonatologists' median response supported an infant-specific BIS conceptualization that linked the infant's and family's interests. They did not support allowing limitations on the family's obligations. Ethicists' supported a conceptualization that linked the infant's and family's interests and limitations on the family's obligations, a less infant-specific conceptualization. Ethicists were less or equally likely to agree with forgoing LST in seven of eight cases.CONCLUSIONS: Ethicists endorsed a conceptualization of the BIS that includes the effects on the family and rejected an infant specific one. Neonatologists split between these two and rejected limiting the family's obligations. Critical appraisal of the BIS is needed in neonatal ethics.