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In the name of the family? Against parents’ refusal to disclose prognostic information to children
Medicine, Health Care and Philosophy ( IF 2.3 ) Pub Date : 2021-04-13 , DOI: 10.1007/s11019-021-10017-4
Michael Rost 1 , Emilian Mihailov 1, 2
Affiliation  

Parents frequently attempt to shield their children from distressing prognostic information. Pediatric oncology providers sometimes follow parental request for non-disclosure of prognostic information to children, invoking what we call the stability of the family argument. They believe that if they inform the child about terminal prognosis despite parental wishes, cohesion and family structure will be severely hampered. In this paper, we argue against parental request for non-disclosure. Firstly, we present the stability of the family argument in more detail. We, then, set out the (conceptual, legal, systemic) entitativity of the family and the kind of value the stability of the family argument assumes, before we set on to critically evaluate the argument. Our analysis shows that disclosure of prognostic information to children does not necessarily destabilize the family to a greater extent than non-disclosure. In fact, a systemic perspective suggests that mediated disclosure is more likely to result in a (long-term) stability of the family than non-disclosure. It is in the interest of the family to resist the initial aversive reaction to delivering bad news. In the final part, we draw a set of recommendations on how to facilitate decision-making in face of parental request for non-disclosure.



中文翻译:

以家人的名义?反对父母拒绝向孩子透露预后信息

父母经常试图保护孩子免受令人痛苦的预后信息的影响。儿科肿瘤医生有时会遵循父母的要求,不向儿童透露预后信息,援引我们所说的家庭争论的稳定性。他们认为,如果不顾父母的意愿,告知孩子末期预后,凝聚力和家庭结构将受到严重阻碍。在本文中,我们反对家长要求保密的要求。首先,我们更详细地介绍家庭论证的稳定性。然后,在我们开始批判性地评估该论证之前,我们首先阐述了家庭的(概念上的、法律上的、系统上的)实体性以及家庭稳定性论证所假设的价值类型。我们的分析表明,向儿童披露预后信息并不一定比不披露更大程度地破坏家庭稳定。事实上,从系统的角度来看,调解披露比不披露更有可能带来家庭的(长期)稳定。抵制最初传递坏消息的厌恶反应符合家庭的利益。在最后一部分,我们针对如何在家长要求保密的情况下促进决策提出了一系列建议。

更新日期:2021-04-13
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