RESUMO
Lately, number of divorces is increasing, nevertheless, a parents' divorce can become a traumatic problem for paediatric patients. Consequently, the aim of this study was to analyze the ethical conflicts that appear in the relationship between physician/parents/son/daughter, and more specifically those that a divorce generates. A descriptive study was developed through a survey composed by 39 items. Previously, an exhaustive bibliographic analysis was carried out. Our results show that only 35% of paediatricians interviewed have been educated in bioethics although this issue is important in daily practice. Other items show that 57,5% would not cancel a pharmacological treatment in order to improve quality of life. Also, they would react against a wrong parents' decision (82,5%). They give low value to the minor`s decision (6,05%), and rarely inform exclusively to adolescents (5%). In contrast, paediatricians sometimes ask to adolescents (20%) in first place and involved them to decide in 90% of cases. Besides, there are differences in the relation with fathers and mothers, 17,5% of mothers are informed exclusively, a fact that never happens with fathers. Ethics has an intrinsic value very important in daily clinical decisions in order to respect the rules and to adapt them to the situation of every paediatric patient. When an important ethical conflict become, as a divorce is, it is essential to know who must be informed and the rights everyone has to make a decision. It is complicated to the paediatricians yet to develop 41/2002 law for Patient's autonomy.
Assuntos
Divórcio/ética , Negociação , Adolescente , Fatores Etários , Bioética/educação , Criança , Custódia da Criança/ética , Direitos Civis , Tomada de Decisão Clínica , Divórcio/legislação & jurisprudência , Educação Médica , Pai , Feminino , Humanos , Consentimento Livre e Esclarecido , Masculino , Mães , Pediatras/educação , Papel do Médico , Relações Profissional-Família , Psicologia do Adolescente , Psicologia da Criança , Consentimento do Representante Legal/ética , Consentimento do Representante Legal/legislação & jurisprudência , Revelação da Verdade/éticaRESUMO
En los últimos años el número de divorcios ha ido aumentando, siendo en ocasiones, para el paciente pediátrico, el divorcio de sus padres un elemento traumático. Nuestro objetivo fue analizar los conflictos éticos que se producen en la relación sanitaria médico-padres-hijo y de forma más específica en niños procedentes de separación/divorcio. Se realizó un estudio descriptivo mediante una encuesta compuesta de 39 items. Previamente se realizó un análisis bibliográfico exhaustivo de artículos relacionados. Nuestros resultados muestran que solo el 35% de los pediatras ha recibido formación en bioética pese a su importancia en la práctica diaria. Sobre otras cuestiones, la mayoría (57,5%) no retiraría el tratamiento de un paciente enfermo pese a que aumentara su calidad de vida, y actuaría ante una decisión equivocada de los padres (82,5%). Dan poco valor a las decisiones del menor (6,05%), raramente informados exclusivamente (5%). En cambio, se les informa primero en un 20% de los casos y en el 90% se les implica. Respecto a los progenitores, el 17,5% de las madres son informadas en exclusiva, nunca los padres. La ética tiene un valor intrínseco muy importante en las decisiones clínicas habituales, respetándose generalmente las normas y adaptándose a la situación particular de cada niño/a. En los casos en los que hay un conflicto importante, como divorcios, es importante conocer a quién se debe informar, y qué derecho tiene cada uno a decidir. Aún resulta difícil para algunos pediatras aplicar la ley 41/2002 de Autonomía del Paciente
Lately, number of divorces is increasing, nevertheless, a parents' divorce can become a traumatic problem for paediatric patients. Consequently, the aim of this study was to analyze the ethical conflicts that appear in the relationship between physician/parents/son/daughter, and more specifically those that a divorce generates. A descriptive study was developed through a survey composed by 39 items. Previously, an exhaustive bibliographic analysis was carried out. Our results show that only 35% of paediatricians interviewed have been educated in bioethics although this issue is important in daily practice. Other items show that 57,5% would not cancel a pharmacological treatment in order to improve quality of life. Also, they would react against a wrong parents' decision (82,5%). They give low value to the minor`s decision (6,05%), and rarely inform exclusively to adolescents (5%). In contrast, paediatricians sometimes ask to adolescents (20%) in first place and involved them to decide in 90% of cases. Besides, there are differences in the relation with fathers and mothers, 17,5% of mothers are informed exclusively, a fact that never hap-pens with fathers. Ethics has an intrinsic value very important in daily clinical decisions in order to respect the rules and to adapt them to the situation of every paediatric patient. When an important ethical conflict become, as a divorce is, it is essential to know who must be informed and the rights everyone has to make a decision. It is complicated to the paediatricians yet to develop 41/2002 law for Patient's autonomy
