肾病患儿家庭在治疗阶段的多重伦理困境及对策探讨基于结构化理论的视角

[中图分类号]R-052 [文献标志码]A [文章编号]1001-8565（2025）10-1240-06

DOI:10.12026/j.issn.1001-8565.2025.10.02

Exploration of multiple ethical dilemmasand countermeasures infamilies of children with kidneydisease in the treatment stage:an analysis from the perspective of structured theory

SUN Rongrong,SHI Juanjuan,YANG Wenjing

(Department ofNephrology，Children's Hospital ofNanjing Medical University,Nanjing 21oooo,China)

Abstract: There are numerous ethical dilemmas in families of children with kidney disease during the treatment stage.From the perspective of Giddens’structured theory，this paper analyzed the ethical dilemmas, such as individual and family wealth disparity at the micro-level,doctor-patient information asymmetry and the atribution of medical decision-making rights at the meso-level，as wellas unequal medical resources andan incomplete medical security system for children at the macro-level.The ethical dilemmas faced by families of childre with kidney disease are the result of the structural constraint effect. The coping strategies they adopt in response to these dilemmas are the basis of structural reproduction and the products of the structural effct.As a group with subjective initiative，they are good at self-reflection.Through repeated cognitive evaluation，they can make a series of efective coping strategies to achieve their own goals,such as relying on family support and linking resources to seek social support，establishing online support groups and building an information sharing platform，assesing children's best-interests judges and safeguarding their reasonable and legitimate rights and interests，planning and allocating high-quality medical resources and promoting the construction of the medical service system，as well as promoting the reform of the basic medical insurance system for children and improve the protection mechanism for major illnesses.

Keywords: structured theory；children with kidney disease；family support； ethical dilemma

儿童慢性肾脏病（chronickidney disease，CKD)是肾脏逐渐失去功能且无法彻底恢复的慢性疾病，其病因可能包括先天异常、遗传因素、感染及其他系统性疾病所引发的肾损伤[1。（剩余9841字）