成長ホルモン療法における倫理的問題

J Lantos¹, M Siegler, L Cuttler

¹Department of Pediatrics, University of Chicago, Pritzker School of Medicine, IL 60637.

JAMA

|February 17, 1989

まとめ

GH欠乏症のない矮小児に対する成長ホルモン (GH) 治療は,倫理的な課題を提示します. そのような治療は,不確実な利益とリスクのため,ルーティンケアではなく,臨床研究の一部であるべきです.

科学分野:

小児内分泌学について
医療倫理医療倫理について
子どもの健康に関する政策

背景:

小児科医は,古典的なGH欠乏症の基準を欠く矮小児に対する成長ホルモン (GH) 治療に関する倫理的なジレンマと闘っています.
生物学的健康基準は,身長,GHの分泌,健康,病気の複雑な関係があるため,GH治療の評価には不十分である.

研究の目的:

文書化されていないGH欠乏症の矮小児に対するGH療法の倫理的検討を評価する.
短身の正常な子供に対するGH治療を,他の生命を脅かさない小児疾患に対する受け入れられた治療法と比較する.

主な方法:

GH療法を取り巻く臨床的および倫理的ジレンマの分析.
GH療法と既定の小児ケアモデル (ウェル・チルドレンケア,美容療法,心理療法,慢性疾患管理) の比較.

主要な成果:

記録された欠乏症のない低身長の子供に対するGH治療は,治療の負担,長期的な不確実な結果,および不明瞭なエンドポイントのために倫理的な懸念を提起します.
現在の小児科の倫理規範は,これらの子供に対するルーティンGH治療をサポートしていません.

結論:

文書化されていないGH欠乏症の矮小児に対する通常のGH治療は,現在の小児の倫理基準を超えています.
このような治療は,倫理的および安全性の懸念に対処するために,包括的な臨床研究プロトコルの中で投与されるべきです.

キーワード:

分析的なアプローチプロフェッショナルの患者との関係性

さらに関連する動画

11:36

A RAPID Method for Blood Processing to Increase the Yield of Plasma Peptide Levels in Human Blood

Published on: April 28, 2016

06:24

Establishment of Rat Models Mimicking Gender-affirming Hormone Therapies

Published on: January 10, 2025

関連する概念動画

00:49

What is Genetic Engineering?

Overview

01:22

Ethics and Bioethics

Ethics is a philosophical study of moral actions. Ethics attempts to determine what is valuable for individuals and society. It examines the rational justification of moral judgments and analyzes what is morally just, fair, and right. Bioethics is a sub-discipline of applied ethics that analyzes the philosophical, social, and legal issues in life sciences and medicine. Ethical theories serve as a foundation for decision-making and represent the viewpoints from which people seek direction. They...

01:27

Ethical Issues

Nurses are essential in patient care, upholding the ethical principles of their profession and effectively navigating ethical dilemmas. Neglecting ethical issues can lead to inadequate patient care, compromised therapeutic relationships, and moral distress among healthcare workers.
Ethical Concerns in Healthcare:

01:17

Ethical Dilemmas I

Ethical dilemmas in nursing are of utmost importance, as they often arise from the tension between adhering to core ethical principles and the practical realities of healthcare delivery. These dilemmas require nurses to navigate complex situations where competing ethical considerations pull them in different directions.
Let us explore some examples to understand the potentially complex moral decisions nurses face.
Take the case of caring for minors, particularly in areas related to reproductive...

01:15

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...

01:26

Cellular Adaptation II: Hypertrophy

Hypertrophy is the increase in the size of individual cells, resulting in the enlargement of a tissue or organ. Unlike hyperplasia, which involves an increase in cell number, hypertrophy is characterized by an increase in cell volume. This process often occurs in response to higher functional demand or hormonal stimulation, leading to the production of more structural proteins and organelles, thereby enhancing the cells' work capacity.There are two primary types of hypertrophy: physiological...

関連する実験動画