Mary E Graham, Shannon Blee, Rebecca D Pentz, Emily Roebuck, Alexander H Hoon, Mara Black
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引用次数: 0
摘要
通过辅助生殖技术(ART)受孕后,父母可能会向儿科医生提出对孩子神经发育的担忧,包括孩子的健康状况是否与使用 ART 有关。儿科医生可能并不熟悉 ART 的过程,也不了解这些家庭在此之前所经历的一切,因此在与家长讨论这些问题时很难为他们提供咨询。在向儿科医生陈述之前,父母已经接受了生殖内分泌专家的广泛评估。在咨询过程中,生殖内分泌专家会提供与抗逆转录病毒疗法相关的母婴风险信息。然而,在这一快速发展的领域,提供全面的、以患者为中心的知情同意越来越复杂,为患者提供适当的咨询可能具有挑战性。如果父母经过了适当的知情同意程序,儿科医生也了解了这一程序的含义,那么儿童的护理就能得到优化。在这篇综述中,我们将讨论产前知情同意程序的复杂性,父母在向儿科医生提出申请前要进行知情同意。我们强调了这些讨论的重要性,并着重强调了伦理原则,以及父母在抗逆转录病毒疗法期间所面临的情感、医疗、法律和经济压力,相信这种理解将改善儿科医生随后提供的护理。
Informed consent in assisted reproductive technology: Implications for pediatric clinicians.
After conceiving through assisted reproductive technologies (ART), parents may present to their pediatrician with concerns related to their child's neurodevelopment, including whether their child's health may be related to their use of ART. Pediatricians may be unfamiliar with the ART process and what the families endured up to this point, resulting in difficulty counseling parents through these discussions. Before presentation to the pediatrician, parents have undergone extensive evaluation with reproductive endocrinologists. During counseling, the reproductive endocrinologist provides information on maternal and childhood risks associated with ART. However, in this rapidly evolving field, providing comprehensive, patient-centered, informed consent is increasingly complex and counseling patients properly can be challenging. When parents have gone through the proper informed consent process, and when the pediatrician has an understanding of what this process entails, care of the child can be optimized. In this review, we discuss the complexities of the prenatal informed consent process that parents navigate before presenting to pediatricians. We emphasize the importance of these discussions and highlight ethical principles, as well as emotional, medical, legal, and financial stressors that parents face during ART, with the belief that this understanding will improve the care that pediatricians subsequently provide.
期刊介绍:
Wiley-Blackwell is pleased to publish Developmental Medicine & Child Neurology (DMCN), a Mac Keith Press publication and official journal of the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) and the British Paediatric Neurology Association (BPNA).
For over 50 years, DMCN has defined the field of paediatric neurology and neurodisability and is one of the world’s leading journals in the whole field of paediatrics. DMCN disseminates a range of information worldwide to improve the lives of disabled children and their families. The high quality of published articles is maintained by expert review, including independent statistical assessment, before acceptance.