NICU面临的伦理问题

中国儿童保健杂志 ›› 2013, Vol. 21 ›› Issue (2): 152-154.

NICU面临的伦理问题

刘敬

北京军区总医院附属八一儿童医院,北京 100700

收稿日期:2012-12-17 发布日期:2013-02-06 出版日期:2013-02-06
作者简介:刘敬(1965-),男,安徽人,主任医师,教授,博士学位,博士生导师,主要研究方向为新生儿疾病。

Received:2012-12-17 Online:2013-02-06 Published:2013-02-06

摘要/Abstract

摘要： 新生儿重症监护与抢救技术的进步,一方面,使既往不能存活的危重新生儿得以健康存活或存活时间延长;另一方面,部分得以存活的极危重患儿留下了严重的远期伤残。最终不能存活或存活后遗留严重伤残则不可避免的带来救治过程中的伦理问题,而且,这一问题不但在发达国家,在我国也显得越来越突出。此外,在医学研究中也存在不可回避的伦理问题。本文对在临床中应遵循的基本伦理原则,如尊重家长的自主权、婴儿最大利益优先原则、无伤害原则、授权与知情权等予以简介。

关键词: 伦理, 婴儿, 新生, 重症

中图分类号:

R722

刘敬. NICU面临的伦理问题[J]. 中国儿童保健杂志, 2013, 21(2): 152-154.

参考文献

[1] Tamaru S,Kikuchi A,Takagi K,et al.Neurodevelopmental outcomes ofvery low birth weight and extremely lowbirthweight infants at 18 months of corrected age associated with prenatal risk factors[J].Early Hum Dev,2011,87:55-59.
[2] Jang DH,Sung IY,Jeon JY,et al.Neurodevelopmental outcomes in very low-birth-weight infants in Korea 1998~2007 vs 1989~1997[J].J Child Neurol,2011,26:1405-1410.
[3] Orzalesi M.Ethical problems in the care of the high risk neonates[J].Journal of Maternal-Fetal Neonatal Medicine,2010,23(S3):7-10.
[4] Huang LC,Chen CH,Liu HL,et al.The attitudes of neonatal professionals towardsend-of-life decision-making for dying infants in Taiwan[J].J Med Ethics,2012,10:1136-1140.
[5] Hellmann J.Medical ethics in neonatal care[M]//Martin RJ,FanaroffAA,Walsh MC.Fanaroff and martin's neonatal-perinatal medicine[M].9th edition.Elsevier Mosby,Louis,USA,2011:33-47.
[6] Kattwinkel J,Perlman JM,Aziz K,et al.Neonatal resuscitation:2010 American heart association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care[J].Circulation,2010,122(S):909-919.
[7] Meadow WL,Lantos JD.Ethics,data,and policy in newborn intensive care[M]//Gleason CA,Devaskar SU.Avery's Diseases of the Newborn.9th edition.Elsevier Saunders,Philadelphia,USA,2011:18-22.
[8] Coby de Boer J,van Blijderveen G,van Dijk G,et al.Implementing structured,multiprofessional medical ethical decision-making in a neonatal intensive care unit[J].J Med Ethics,2012,38:596-601.
[9] National Association of Neonatal Nurses.NICU nurse involvementin ethicaldecisions(treatment of critically Ill newborns)[J].Adv Neonatal Care,2007,7:267-268.
[10] Mancuso T,Burns J.Ethical concerns in the management of pain in the neonate[J].Pediatric Anesthesia,2009,19:953-957.
[11] Batton DG,Barrington KJ,Wallman C.Prevention and management of pain in the neonate:an update[J].Pediatrics,2006,118:2231-2241.
[12] Choonara I.Ethical and safety aspects of clinical trials in neonates[J].Early Hum Dev,2009,85(10S):19-20.
[13] Amin SB,McDermott MP,Shamoo AE.Clinical trials of drugs used off-labelin neonates:ethical issues and alternative study designs[J].Account Res,2008,15:168-187.
[14] Allmark P,Spedding M.Clinical trials in neonates:Ethical issues[J].Semin Fetal Neonatal Med,2007,12:318-323.
[15] Coscia A,Bertino E,Tonetto P,et al.Communicative strategies in a neonatal intensive care unit[J].Journal of Maternal-Fetal and Neonatal Medicine,2010,23(S3):11-13.