The specifics of diagnosis in pediatry: theoretical, medical and bioethical aspects

Abstract

Introduction. In medicine diagnosis is the process of establishing the diagnosis by identifying the nature and cause of a particular disease, symptom or condition of the patient. The necessity of diagnosis establishment comes not so much from a desire to know the absolute truth, but rather to act in the patient's benefit. In pediatrics, the diagnosis is a process especially complex. Dilemma of uncertainty in pediatric diagnostic occurs because of insufficient clinical data, the inability or limited ability of children to communicate. Since decisions in pediatrics are processes that involve analysis and synthesis of all the data, the relationship doctor-parent has an important role. Also in the process of establishing the diagnosis, clinicians may face a number of moral dilemmas. Philosophy of contemporary medicine supports the hypothesis that the efficiency of medical care can be ensured by guiding principles of bioethics.

Objective of the study. To identify theoretical, medical and bioethical aspects in the diagnosis in pediatrics.

Material and methods. The literature review included scientific publications, statistical data, proceedings of conference materials. There were applied the methods of analysis and synthesis, descriptive, induction, deduction, sociological, medical, historical, and biostatistical.

Results. At the stage of diagnosis establishment in pediatrics, medical and ethical issues can arise at any element of the linker: doctor - parent – sick child. To establish a correct diagnosis in pediatrics, must be taken into account clinical and medical factors, as well as the sensitivity and vulnerability of the patient, psychological factors, diagnostic uncertainty, costs, and risks. In pediatrics can be delimited the following main bioethical aspects: the prevailing of paternalistic model; denying methods of diagnosis / treatment proposed because of ethical, religious or insufficient information; the negative influence of external factors on the decisions they take parents on child health; lack of social organizations; lack of ethics committees in health care organizations or their inefficiencies.

Conclusions. Diagnosis stage in pediatric medical care is a complex, multidimensional process. So, the specificity of diagnosis in pediatrics is defined as an art where the doctor knows how to combine intellect, knowledge, skills and moral behavioral science and communication. Besides theoretical, medical and clinical aspects, guidance and the respect of bioethical principles are essential in achieving the goals of care.