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題名:同意與贊同--青少年接受骨髓移植之倫理考量
書刊名:護理雜誌
作者:洪筱瑩黃美智
作者(外文):Hung, Hsiao-yingHuang, Mei-chih
出版日期:2014
卷期:61:4
頁次:頁83-89
主題關鍵詞:骨髓移植最佳利益原則青少年倫理贊同Bone marrow transplantationBest interest standardParental consentAssent
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(4) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:4
  • 共同引用共同引用:0
  • 點閱點閱:6
為罹癌兒童進行骨髓移植治療乃為拯救性命或治癒疾病,然該治療常伴隨嚴重副作用,讓孩童身心靈飽受痛苦與磨難,故治療過程常令人質疑是否真正使病人受惠。再者兒科醫療照護中往往忽略孩子的治療意願與偏好,治療與否的決定多以取得父母之同意為主,故本文將針對此現象,以最佳利益觀點為基礎,應用兒科醫療倫理中對青少年行使同意權及贊同權之論述,分析一位青少年接受骨髓移植之倫理決策過程,最後提出治療過程中醫護人員應盡力維護兒童之贊同權,然而亦不可忽略父母為兒童醫療照護之重要決策角色,故應透過溝通讓父母瞭解兒童贊同之重要性,並在符合父母及家庭之期待下,促成孩子與父母間之溝通與協商,以嘗試解決照護困境。倘若父母與孩子的治療意願衝突仍無法解決,必要時可尋求醫院的倫理委員會協助,以便能取得更周全的建議與可行之策略。
Bone marrow transplantation (BMT) is a frequently considered treatment option for terminal childhood cancer. However, the side effects of BMT frequently cause short- and long-term physical discomfort and spiritual suffering, which significantly impact patient quality of life. In Taiwan, parental consent is typically given priority over the assent of children in medical decisions. This article uses a case of an adolescent patient with neuroblastoma undergoing BMT to discuss the best interest standard and contradictions between the consent of parents and the assent of their children. This article argues that medical staffs are responsible to protect the right of children to fully consider and influence the decisions related to their treatment options. Medical staffs should communicate to parents the importance of their children's assent and promote better communication between parents and their children in order to achieve the best outcome for the family as a whole. When mutual communication is unable to resolve conflicts between parents and their children, we recommend seeking assistance from the ethics committee in the hospital.
期刊論文
1.Abrams, A. N.、Hazen, E. P.、Penson, R. T.(2007)。Psychosocial issues in adolescents with cancer。Cancer Treatment Reviews,33(7),622-630。  new window
2.Bendorf, A.、Kerridge, I. H.(2011)。Ethical issues in bone marrow transplantation in children。Journal of Paediatrics and Child Health,47(9),614-619。  new window
3.Bowman, K. W.、Hui, E. C.(2000)。Bioethics for clinicians: 20. Chinese bioethics。CMAJ: Canadian Medical Association Journal,163(11),1481-1485。  new window
4.De Lourdes Levy, M.、Larcher, V.、Kurz, R.、Ethics Working Group of the Confederation of European Specialists in Paediatrics(2003)。Informed consent/assent in children. Statement of the Ethics Working Group of the Confederation of European Specialists in Paediatrics (CESP)。European Journal of Pediatrics,162(9),629-633。  new window
5.De Vries, M. C.、Wit, J. M.、Engberts, D. P.、Kaspers, G. J. L.、Van Leeuwen, E.(2010)。Pediatric oncologists' attitudes towards involving adolescents in decision-making concerning research participation。Pediatric Blood & Cancer,55(1),123-128。  new window
6.Fish, J. D.、Grupp, S. A.(2008)。Stem cell transplantation for neuroblastoma。Bone Marrow Transplantation,41(2),159-165。  new window
7.Hein, I. M.、Troost, P. W.、Lindeboom, R.、de Vries, M. C.、Zwaan, C. M.、Lindauer, R. J.(2012)。Assessing children’s competence to consent in research by a standardized tool: A validity study。BMC Pediatrics,12,156-10。  new window
8.Hobbie, W. L.、Moshang, T.、Carlson, C. A.、Goldmuntz, E.、Sacks, N.、Goldfarb, S. B.、Ginsberg, J. P.(2008)。Late effects in survivors of tandem peripheral blood stem cell transplant for high-risk neuroblastoma。Pediatric Blood & Cancer,51(5),679-683。  new window
9.Hokkanen, H.、Eriksson, E.、Ahonen, O.、Salantera, S.(2004)。Adolescents with cancer: Experience of life and how it could be made easier。Cancer Nursing,27(4),325-335。  new window
10.Kars, M. C.、Grypdonck, M. H. F.、van Delden, J. J. M.(2011)。Being a parent of a child with cancer throughout the end-of-life course。Oncology Nursing Forum,38(4),260-271。  new window
11.Kopelman, Loretta M.(2007)。The best interests standard for incompetent or incapacitated persons of all ages。The Journal of Law, Medicine & Ethics,35(1),187-196。  new window
12.Larcher, V.(2005)。Consent, competence, and confidentiality。BMJ: British Medical Journal,330(7487),353-356。  new window
13.Lee, K. J.、Havens, P. L.、Sato, T. T.、Hoffman, G. M.、Leuthner, S. R.(2006)。Assent for treatment: clinician knowledge, attitudes, and practice。Pediatrics,118(2),723-730。  new window
14.Levetown, M.、American Academy of Pediatrics, Committee on Bioethics(2008)。Communicating with children and families: From everyday interactions to skill in conveying distressing information。Pediatrics,121(5),1441-1460。  new window
15.Moody, K.、Siegel, L.、Scharbach, K.、Cunningham, L.、Cantor, R. M.(2011)。Pediatric palliative care。Primary Care: Clinics in Office Practice,38(2),327-361。  new window
16.Park, J. R.、Eggert, A.、Caron, H.(2008)。Neuroblastoma: Biology, prognosis, and treatment。Pediatric Clinics of North America,55(1),97-120。  new window
17.Pate, M. F. D.(2013)。Assent and dissent in pediatric progressive and critical care。AACN Advanced Critical Care,24(4),356-359。  new window
18.Spriggs, M.、Caldwell, P. H. Y.(2011)。The ethics of paediatric research。Journal of Paediatrics and Child Health,47(9),664-667。  new window
19.Unguru, Y.、Coppes, M. J.、Kamani, N.(2008)。Rethinking pediatric assent: From requirement to ideal。Pediatric Clinics of North America,55(1),211-222。  new window
20.Wheeler, I.(2001)。Parental bereavement: The crisis of meaning。Death Studies,25(1),51-66。  new window
21.Whitney, S. N.、Ethier, A. M.、Frugé, E.、Berg, S.、McCullough, L. B.、Hockenberry, M.(2006)。Decision making in pediatric oncology: Who should take the lead? The decisional priority in pediatric oncology model。Journal of Clinical Oncology,24(1),160-165。  new window
22.Zage, P. E.、Kletzel, M.、Murray, K.、Marcus, R.、Castleberry, R.、Zhang, Y.、Children’s Oncology Group(2008)。Outcomes of the POG 9340/9341/9342 trials for children with high-risk neuroblastoma: A report from the Children’s Oncology Group。Pediatric Blood & Cancer,51(6),747-753。  new window
23.Freyer, D. R.(2004)。Care of the dying adolescent: Special considerations。Pediatrics,113(2),381-338。  new window
24.American Academy of Pediatrics, Committee on Bioethics(1995)。Academy of Pediatrics, Committee on Bioethics. Informed consent, parental permission, and assent in pediatric practice。Pediatrics,95(2),314-317。  new window
圖書
1.Beauchamp, T. L.、Childress, J. F.(2013)。Principles of biomedical ethics。New York, NY:Oxford University Press。  new window
2.Carter, B. S.、Levetown, M.、Friebert, S. E.(2011)。Palliative care for infants, children, and adolescents: A practical handbook。Baltimore, ML:Johns Hopkins University Press。  new window
3.Miller, G.(2010)。Pediatric bioethics。New York, NY:Cambridge University Press。  new window
4.Jonsen, Albert R.、Siegler, Mark、Winslade, William J.、辛幸珍、許正園、陳汝吟、陳彥元、蔡篤堅(2011)。臨床倫理學:臨床醫學倫理決策的實務導引。臺北:麥格羅希爾。  延伸查詢new window
5.張春興(2007)。教育心理學:三化取向的理論與實踐。東華。  延伸查詢new window
其他
1.Pasquini, M. C.,Wang, Z.(201203)。Current use and outcome of hematopoietic stem cell transplantation: CIBMTR summary slides,http://www.cibmtr.org/pages/index.aspx。  new window
2.Shohet, J. M.,Nuchtern, J. G.(201303)。Treatment and prognosis of neuroblastoma,http://www.uptodate.com/contents/treatment-andprognosis-of-neuroblastoma。  new window
圖書論文
1.Frankel, L. R.、DiCarlo, J. V.(2005)。Ethical problems encountered with oncology and bone marrow transplant patients。Ethical dilemmas in pediatrics: Cases and commentaries。New York, NY:Cambridge University Press。  new window
 
 
 
 
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