儿童对心脏手术的理解和同意:多学科团队合作与道德体验。

IF 1.3 4区 医学 Q3 NURSING
Journal of Child Health Care Pub Date : 2023-06-01 Epub Date: 2022-09-27 DOI:10.1177/13674935221100419
Priscilla Alderson, Hannah Bellsham-Revell, Nathalie Dedieu, Liz King, Rosa Mendizabal, Katy Sutcliffe
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引用次数: 0

摘要

有关儿童手术同意书的主流法律和伦理文献与在两个心脏外科中心观察到的儿童和成人的道德体验形成了鲜明对比。研究人员对 45 名从业人员和相关专家、16 个接受非急诊手术的 6 至 15 岁儿童的家庭进行了访谈,并进行了在线调查。专题数据分析参考了批判现实主义和童年研究。这种观点建立在二分法的基础上:成人/儿童、胜任/不胜任、尊重或保护儿童、告知或分散儿童注意力、迅速或灵活地利用时间、语言/非语言交流、尊重或控制儿童以及理性/情感。通过理解幼儿对与心脏手术有关的复杂痛苦决定的推理和情感,成人与幼儿分享知识、控制、信任和尊重。他们将儿童在非紧急手术前的同意或拒绝视为儿童生命历程中共同的个人道德体验,而不仅仅是遵守法律。成人帮助儿童理解并 "想要 "手术,因为手术能提供他们所珍视的东西:更好的健康或 "更像他们的朋友"。如果儿童不被说服,手术有时会被推迟,有时会被取消。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Children's understanding and consent to heart surgery: Multidisciplinary teamwork and moral experiences.

Children's understanding and consent to heart surgery: Multidisciplinary teamwork and moral experiences.

Children's understanding and consent to heart surgery: Multidisciplinary teamwork and moral experiences.

Mainstream law and ethics literature on consent to children's surgery contrasts with moral experiences of children and adults observed in two heart surgery centres. Research interviews were conducted with 45 practitioners and related experts, and with 16 families of children aged 6 to 15, admitted for non-urgent surgery, as well as an online survey. Thematic data analysis was informed by critical realism and childhood studies.Impersonal adult-centric mainstream literature assumes young children cannot consent. It is based on dichotomies: adult/child, competent/incompetent, respect or protect children, inform or distract them, use time swiftly or flexibly, verbal/non-verbal communication, respect or control children and reason/emotion.Through their moral experiences, adults and children resolve these seeming dichotomies. Through understanding young children's reasoning and emotions about complex distressing decisions related to heart surgery, adults share knowledge, control, trust and respect with them. They see children's consent or refusal before non-urgent surgery as a shared personal moral experience within the child's life course, beyond mere legal compliance. Adults help children to understand and 'want' the surgery that offers things they value: better health or to 'be more like their friends'. If children are not convinced, sometimes surgery is postponed or occasionally cancelled.

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来源期刊
Journal of Child Health Care
Journal of Child Health Care NURSING-PEDIATRICS
CiteScore
4.10
自引率
15.80%
发文量
60
审稿时长
>12 weeks
期刊介绍: Journal of Child Health Care is a broad ranging, international, professionally-oriented, interdisciplinary and peer reviewed journal. It focuses on issues related to the health and health care of neonates, children, young people and their families, including areas such as illness, disability, complex needs, well-being, quality of life and mental health care in a diverse range of settings. The Journal of Child Health Care publishes original theoretical, empirical and review papers which have application to a wide variety of disciplines.
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