新生児重症病棟の新生児がエイズに罹患するリスクがある場合の治療の選択
B W Levin1, J M Driscoll, A R Fleischman
1Department of Health and Nutrition Sciences, Brooklyn College, NY 11210.
JAMA
|June 12, 1991
まとめ
医療従事者は,関連のない疾患であっても,HIVのリスクのある乳児に対して,より積極的な治療を提供することがあります. 実際の感染ではなく,この認識されたリスクが,新生児の重症ケアに関する決定に影響を与えます.
科学分野:
- 医療倫理 医療倫理について
- 新生児集中治療室の新生児集中治療室の新生児集中治療室の新生児集中治療室の新生児集中治療室
- 公衆衛生は公衆衛生である.
背景:
- ヒト免疫不全ウイルス (HIV) に感染した母親から生まれた乳児は,感染のリスクが高い.
- 新生児重症治療室 (NICU) は,HIV感染の可能性のある乳児を頻繁に診療しています.
- これらの脆弱な乳児に対する医療従事者の治療勧告を理解することは極めて重要です.
研究 の 目的:
- HIVのリスクのある乳児の治療に関するNICUの専門家の態度を調査する.
- 認知されたHIVステータスが,非HIV関連疾患の治療決定に影響を与えるかどうかを評価する.
主な方法:
- ニューヨーク市の6つのNICUで247人の医療従事者にアンケートが行われました.
- 回答者には,HIVリスクステータスが異なる乳児を含むシナリオが提示されました.
- HIVに関連していない疾患に対する治療推奨は,HIVリスクの認識に基づいて比較されました.
主要な成果:
- 専門家の有意な割合は,リスクのない乳児と比較して,HIVに感染するリスクのある乳児に対して,より積極的な治療を推奨しています.
- HIV関連でない疾患に対する手術の推薦は,HIVリスクが存在するか確認された場合に顕著に減少しました.
- 確認された感染ではなく,知覚されたHIVステータスが治療決定に影響を与えたようです.
結論:
- 認知されたHIVステータスは,関係のない状態でも,重症児の治療決定に大きく影響を与えることができます.
- このバイアスは,実際にHIVに感染していない乳児に影響を与える可能性があります.
- 臨床的意思決定におけるHIVステータスの関連性に関する倫理的考察は,緊急に検討する必要がある.
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