Severe cognitive disability, medically complex children and long-term ventilation.

IF 1.6 Q2 ETHICS
Helen Turnham, Dominic Wilkinson
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引用次数: 0

Abstract

Children with complex medical conditions including those with severe intellectual disability are living longer. For some, support with medical technology such as Long-Term Ventilation can prolong their lives further. Such technological supports can have significant implications for the child and her family and consume considerable resources though they can also offer real benefits. Sometimes clinicians question whether children with very severe cognitive impairments should have their life prolonged by technology, though they would be prepared to provide the same treatment in equivalent cases without cognitive disability. We describe and analyse four ways in which this view might be justified. Although it could be claimed that children with severe cognitive disability have lives that are not worth living, in most cases this view can and should be rejected. However, the burdens of life-prolonging technology may outweigh the benefits of such treatment either in the present or in the future. Consequently it might not be in their interests to provide such technology, or to ensure that it is provided as part of a time-limited trial. We also consider circumstances where medical technology could offer modest benefits to an individual, but resources are scarce. In the face of resource imitation, treatment may be prioritised to children who stand to benefit the most. This may in some circumstances, justify selectively withholding treatment from some medically complex children.

严重认知障碍,医学复杂的儿童和长期通气。
患有复杂疾病的儿童,包括患有严重智力残疾的儿童,寿命更长。对一些人来说,长期通气等医疗技术的支持可以进一步延长他们的生命。这种技术支助对儿童及其家庭有重大影响,虽然也能带来实际的好处,但也会消耗大量资源。有时,临床医生会质疑是否应该通过技术延长患有严重认知障碍的儿童的生命,尽管他们愿意为没有认知障碍的同等病例提供同样的治疗。我们描述和分析了这一观点可能被证明是正确的四种方式。虽然可以声称患有严重认知障碍的儿童的生活不值得过,但在大多数情况下,这种观点可以而且应该被拒绝。然而,无论是在现在还是在将来,延长生命技术的负担都可能超过这种治疗的好处。因此,提供这种技术或确保作为有时间限制的试验的一部分提供这种技术可能不符合它们的利益。我们还考虑到医疗技术可以为个人提供适度好处,但资源稀缺的情况。面对资源模仿,治疗可能会优先考虑那些受益最大的儿童。在某些情况下,这可能成为有选择地拒绝对某些医学上复杂的儿童进行治疗的理由。
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来源期刊
CiteScore
2.70
自引率
6.20%
发文量
16
期刊介绍: Monash Bioethics Review provides comprehensive coverage of traditional topics and emerging issues in bioethics. The Journal is especially concerned with empirically-informed philosophical bioethical analysis with policy relevance. Monash Bioethics Review also regularly publishes empirical studies providing explicit ethical analysis and/or with significant ethical or policy implications. Produced by the Monash University Centre for Human Bioethics since 1981 (originally as Bioethics News), Monash Bioethics Review is the oldest peer reviewed bioethics journal based in Australia–and one of the oldest bioethics journals in the world. An international forum for empirically-informed philosophical bioethical analysis with policy relevance. Includes empirical studies providing explicit ethical analysis and/or with significant ethical or policy implications. One of the oldest bioethics journals, produced by a world-leading bioethics centre. Publishes papers up to 13,000 words in length. Unique New Feature: All Articles Open for Commentary
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