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Cuestiones éticas en la terapia de la hormona del crecimiento
J Lantos1, M Siegler, L Cuttler
1Department of Pediatrics, University of Chicago, Pritzker School of Medicine, IL 60637.
JAMA
|February 17, 1989
Resumen
La terapia de la hormona del crecimiento (GH) para niños pequeños sin deficiencia de GH presenta desafíos éticos. Dicho tratamiento debe ser parte de la investigación clínica, no de la atención de rutina, debido a los beneficios y riesgos inciertos.
Área de la Ciencia:
- Endocrinología Pediátrica Endocrinología pediátrica.
- Ética médica y ética médica.
- Política de Salud Infantil Política de Salud Infantil
Sus antecedentes:
- Los pediatras se enfrentan a dilemas éticos con respecto a la terapia de la hormona del crecimiento (GH) para niños bajos que carecen de los criterios clásicos de deficiencia de GH.
- Las normas de salud biológica son insuficientes para evaluar la terapia de GH debido a la compleja relación entre la estatura, la secreción de GH, la salud y la enfermedad.
Objetivo del estudio:
- Evaluar las consideraciones éticas de la terapia de GH para niños pequeños sin deficiencia documentada de GH.
- Comparar la terapia de GH para niños normales de baja estatura con tratamientos aceptados para otras afecciones pediátricas no potencialmente mortales.
Principales métodos:
- Análisis de los dilemas clínicos y éticos que rodean la terapia de GH.
- Comparación de la terapia de GH con los modelos de atención pediátrica establecidos (cuidado de niños sanos, terapia cosmética, tratamiento psicológico, manejo de enfermedades crónicas).
Principales resultados:
- La terapia de GH para niños pequeños sin deficiencia documentada plantea preocupaciones éticas debido a las cargas de tratamiento, resultados inciertos a largo plazo y puntos finales poco claros.
- Las normas éticas pediátricas actuales no apoyan la terapia de rutina de GH para estos niños.
Conclusiones:
- La terapia rutinaria de GH para niños pequeños sin deficiencia documentada de GH se encuentra fuera de las normas éticas pediátricas actuales.
- Dicha terapia debe administrarse dentro de protocolos completos de investigación clínica para abordar las preocupaciones éticas y de seguridad.
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