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加强临床医生提供知情同意书和咨询服务的能力:一些教学策略。

Enhancing clinician provision of informed consent and counseling: some pedagogical strategies.

作者信息

Wear S

机构信息

State University of New York at Buffalo, USA.

出版信息

J Med Philos. 1999 Feb;24(1):34-42. doi: 10.1076/jmep.24.1.34.2539.

Abstract

Although long touted as an ethical and legal requirement, some clinicians still seem to offer less than fully adequate informed consent processes; similarly the counseling of patients and families, particularly about post-intervention scenarios, is often perfunctory at best. Keyed to a narrative of a patient's experience with surgery for a deviated septum, this article reflects on why such less than adequate clinician behaviors tend to occur and what might be done about them. Certain legal misconceptions about informed consent are highlighted in this reflection, as well as why certain clinicians seem to take such a narrow view of their responsibilities to patients. Further reference in this regard is also made to a recently constructed module on informed consent for medical residents. In it, though legal requirements for informed consent are reviewed, the basic perspective taken regards informed consent as a clinical intervention that pursues certain basic goods and values, only one of which lies in determining when legal closure for such processes has occurred.

摘要

尽管长期以来一直被视为一项伦理和法律要求,但一些临床医生似乎仍然没有提供充分的知情同意程序;同样,对患者及其家属的咨询,尤其是关于干预后情况的咨询,往往至多只是敷衍了事。以一位患者鼻中隔偏曲手术经历的叙述为切入点,本文反思了为何会出现这种临床医生行为不充分的情况以及对此可采取什么措施。本次反思突出了关于知情同意的某些法律误解,以及为何某些临床医生似乎对他们对患者的责任持如此狭隘的观点。在这方面还进一步提及了最近为住院医生构建的一个关于知情同意的模块。在该模块中,虽然回顾了知情同意的法律要求,但所采取的基本观点将知情同意视为一种追求某些基本利益和价值的临床干预,其中只有一个利益和价值在于确定此类程序何时实现法律上的终结。

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