小儿代谢和减肥手术的当代伦理考虑。

IF 2.4 2区 医学 Q1 PEDIATRICS
Marla A Sacks, Catherine Hunter, Patrick J Javid, Baddr A Shakhsheer
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引用次数: 0

摘要

背景:小儿肥胖症的发病率持续大幅上升。虽然代谢与减肥手术(MBS)在这一人群中具有疗效,并得到了高质量数据的支持,但仍未得到充分利用。本文旨在讨论当前儿科代谢减重手术的伦理问题、考虑因素和争议:方法/结果:本文通过三个案例研究来说明与小儿多器官功能障碍相关的伦理问题:1)一名患有肥胖症且父母不支持的青少年;2)一名患有病态肥胖症且发育迟缓的青少年;3)一名因肝脏脂肪变性而导致严重肝损伤的幼儿:结论:小儿肥胖症的发病率呈指数上升趋势,越来越多的病例对改变生活方式和药物疗法产生了抗药性。儿童代谢和减肥手术(MBS)疗效显著,应引起多学科深思熟虑的讨论,以便为患者提供最佳帮助,而不论其种族、民族或社会经济地位如何。决策制定需要考虑患者的同意、家长/监护人的同意以及当前和未来风险的平衡。为患者提供护理的医疗人员应使用 "肥胖友好型 "语言,以减少耻辱感:证据等级:V 级。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Contemporary Ethical Considerations for Pediatric Metabolic and Bariatric Surgery.

Background: The prevalence of pediatric obesity continues to increase dramatically. Though metabolic and bariatric surgery (MBS) is efficacious and is supported by high-quality data in this population, it remains underutilized. This paper aims to discuss current ethical concerns, considerations, and controversies of pediatric MBS.

Methods/results: Three case studies are utilized to illustrate ethical issues related to pediatric MBS: 1) a teenager with obesity and an unsupportive parent; 2) a teenager with morbid obesity and developmental delay; and 3) a young child with severe liver damage from hepatic steatosis.

Conclusions: The prevalence of pediatric obesity is rising exponentially with more cases resistant to lifestyle modifications and medical therapies. Metabolic and bariatric surgery (MBS) in children is efficacious and should prompt thoughtful multi-disciplinary discussion to best help the patient regardless of racial, ethnic, or socioeconomic status. Decision making involves consideration of patient assent, parent/guardian consent, and balance of current and future risk. Providers caring for patients should utilize "obesity-friendly" language to lessen stigma.

Level of evidence: Level V.

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来源期刊
CiteScore
1.10
自引率
12.50%
发文量
569
审稿时长
38 days
期刊介绍: The journal presents original contributions as well as a complete international abstracts section and other special departments to provide the most current source of information and references in pediatric surgery. The journal is based on the need to improve the surgical care of infants and children, not only through advances in physiology, pathology and surgical techniques, but also by attention to the unique emotional and physical needs of the young patient.
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