ETHICAL CONSIDERATIONS IN PEDIATRIC SURGERY: DISCUSSING INFORMED CONSENT, PARENTAL RIGHTS, AND DECISION-MAKING IN COMPLEX CASES

Аннотация

Ethical aspects in pediatric surgery represent a special area of medical practice where the interests of the child, parents, and medical professionals intersect. The purpose of this study is to analyze modern approaches to informed consent, parental rights, and decision-making in complex clinical situations. The study involved 450 pediatric surgeons and 320 parents from five multidisciplinary hospitals in Europe and Central Asia. The obtained data showed that only 37% of doctors involve children over 12 in the decision-making process, despite the recommendations of international organizations. In 64% of cases, doctors encountered disagreements from parents, and 17% of such situations required intervention from the ethics committee or judicial authorities. Significant cultural differences were also identified: in Central Asia, parental opinion dominance was noted in 83% of cases, compared to 51% in European clinics (p<0.01). The results highlight the need to develop unified protocols, improve the effectiveness of ethics committees, and implement medical ethics programs in the educational process. Strengthening the role of joint decision-making, taking into account the child's opinion, can improve the ethical stability and quality of medical care in pediatric surgery.