<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1665-1146</journal-id>
<journal-title><![CDATA[Boletín médico del Hospital Infantil de México]]></journal-title>
<abbrev-journal-title><![CDATA[Bol. Med. Hosp. Infant. Mex.]]></abbrev-journal-title>
<issn>1665-1146</issn>
<publisher>
<publisher-name><![CDATA[Instituto Nacional de Salud, Hospital Infantil de México Federico Gómez]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1665-11462015000300208</article-id>
<article-id pub-id-type="doi">10.1016/j.bmhimx.2015.06.003</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Consentimiento informado y rechazo de los padres al tratamiento médico en edad pediátrica. El umbral de la tolerancia médica y social. Parte I]]></article-title>
<article-title xml:lang="en"><![CDATA[Informed consent and parental refusal to medical treatment in childhood. The threshold of medical and social tolerance. Part I]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Guadarrama-Orozco]]></surname>
<given-names><![CDATA[Jessica H.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Garduño Espinosa]]></surname>
<given-names><![CDATA[Juan]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vargas López]]></surname>
<given-names><![CDATA[Guillermo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Viesca Treviño]]></surname>
<given-names><![CDATA[Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Infantil de México Federico Gómez Servicio de la Dirección de Investigación ]]></institution>
<addr-line><![CDATA[México D.F.]]></addr-line>
<country>MX</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Infantil de México Federico Gómez Subdireccción de Gestión de la Investigación ]]></institution>
<addr-line><![CDATA[México D.F.]]></addr-line>
<country>MX</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Infantil de México Federico Gómez Unidad de Medicina Basada en Evidencias ]]></institution>
<addr-line><![CDATA[México D.F.]]></addr-line>
<country>MX</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Universidad Nacional Autónoma de México Facultad de Medicina Departamento de Historia y Filosofía de la Medicina]]></institution>
<addr-line><![CDATA[México D.F.]]></addr-line>
<country>MX</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2015</year>
</pub-date>
<volume>72</volume>
<numero>3</numero>
<fpage>208</fpage>
<lpage>214</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S1665-11462015000300208&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S1665-11462015000300208&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S1665-11462015000300208&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[El consentimiento informado es un derecho de todos los individuos y nadie puede obligar a ninguna persona a recibir un tratamiento en contra de su voluntad. Este derecho de aceptar o rechazar un tratamiento no desaparece en los individuos que son incompetentes desde un punto de vista legal: este se ejerce en su nombre por un tercero. A los niños se les considera incompetentes para la toma de decisiones médicas respecto de su propia salud, y son sus padres o tutores legales quienes en nombre del niño deben tomar estas decisiones. Sin embargo la autoridad de los padres no es absoluta, y existen situaciones en las que sus decisiones no son las mejores; en ocasiones incluso llegan a poner en riesgo el bienestar y hasta la vida de sus hijos, obligando al Estado a intervenir en nombre del mejor interés del menor. Es por ello que es necesario plantearse las siguientes preguntas: ¿es el interés superior del niño lo que nos mueve a intervenir judicialmente cuando un padre se rehúsa a aceptar el tratamiento médico propuesto, o es el daño que se le causa al menor con esta decisión? ¿Qué tipo de decisiones paternas son las que no deben de tolerarse? Después de hacer una revisión del tema concluiremos que si la decisión de los padres respecto a una decisión médica a tomar en relación con la salud de sus hijos se juzga hecha con maleficencia, es decir dañina para el menor, se justifica que el Estado intervenga. En la segunda parte de este artículo exponemos cuatro criterios que pueden ser utilizados en la toma de decisiones de casos complejos, donde los padres rehúsan aceptar el tratamiento para sus hijos.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Informed consent is a right of all individuals and no one can force anyone to receive treatment against their wishes. The right to accept or refuse treatment persists in individuals who are incompetent from a legal point of view; this is exercised on their behalf by a third party. Children are considered incompetent to make medical decisions about their own health and their parents or legal guardians are empowered to make those decisions. However, parental authority is not absolute and there are situations where their decisions are not the best, sometimes leading to jeopardizing the well-being and even the lives of their children, forcing the state to intervene on behalf of the best interests of the child. This is the reason why it is necessary to ask the following questions: is it really the child's best interest that moves us to legally intervene when a parent refuses to accept the proposed medical treatment or is the damage done to make this decision? What kind of parental decisions are those that should not be tolerated? After a review of the theme, we conclude that if the decision of the parents regarding a medical decision is considered to be made with maleficence that is harmful to the child, it is justified that the State intervenes. Finally, we exposed four criteria that can be used in making decisions in complex cases where parents refuse treatment for their children.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Interés superior]]></kwd>
<kwd lng="es"><![CDATA[Maleficencia]]></kwd>
<kwd lng="es"><![CDATA[Beneficencia]]></kwd>
<kwd lng="es"><![CDATA[Consentimiento informado del menor]]></kwd>
<kwd lng="es"><![CDATA[Negación paterna del tratamiento médico]]></kwd>
<kwd lng="es"><![CDATA[Parens patriae]]></kwd>
<kwd lng="es"><![CDATA[Derechos del Niño]]></kwd>
<kwd lng="en"><![CDATA[Best interest standard]]></kwd>
<kwd lng="en"><![CDATA[Maleficence]]></kwd>
<kwd lng="en"><![CDATA[Beneficence]]></kwd>
<kwd lng="en"><![CDATA[Informed consent]]></kwd>
<kwd lng="en"><![CDATA[Parental refusal]]></kwd>
<kwd lng="en"><![CDATA[medical treatment]]></kwd>
<kwd lng="en"><![CDATA[Parens patriae]]></kwd>
<kwd lng="en"><![CDATA[Rights of the Child]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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