Walter P
Baruch College, City University of New York, USA.
Issues Law Med. 1999 Spring;14(4):357-73.
In this article, the author compares and contrasts the notion of informed consent in medical decision making in the Western legal system with the traditional Jewish biblical legal system. Walter critically examines the philosophical underpinnings of disease and medical healing in both legal systems, and describes the practical consequences that emanate from the different ideologies in terms of the individual's rights of choice of treatment. She explains that the Western system is predicated on notions of individual autonomy and self determination. Patients therefore have the autonomous ability to select and direct their own medical therapy. By contrast, the traditional biblical system of law is based on the concept that the body does not belong to the individual. Instead, the body is given to man by God as a trust to respect and preserve. Therefore, the individual patients "has no absolute right to control his body and ... he has no real decision making power as to medical treatment choices." In the Jewish biblical tradition, consent is not necessary for obviously beneficial or obviously non-beneficial procedures; consent is only necessary in decisions with uncertain outcomes or when making choices between equal options. Patients are encouraged to seek the counsel of religious authorities and to conform to rabbinical interpretations of the traditional Jewish law.
在本文中，作者将西方法律体系中医疗决策里的知情同意概念与传统犹太圣经法律体系进行了比较和对比。沃尔特批判性地审视了这两种法律体系中疾病与医学治疗的哲学基础，并描述了不同意识形态在个人治疗选择权利方面所产生的实际后果。她解释说，西方体系基于个人自主和自决的观念。因此，患者有自主能力选择并指导自己的医疗治疗。相比之下，传统的圣经法律体系基于这样一种观念，即身体并不属于个人。相反，身体是上帝托付给人类的，要予以尊重和保护。所以，个体患者“没有绝对权利控制自己的身体，而且……在医疗治疗选择方面他没有真正的决策权”。在犹太圣经传统中，对于明显有益或明显无益的程序，同意并非必要；只有在结果不确定的决策中或在同等选项间进行选择时，同意才是必要的。鼓励患者寻求宗教权威的建议，并遵从拉比对传统犹太法律的解释。
