Doyal L
St Bartholomew's and The Royal London School of Medicine and Dentistry, Queen Mary & Westfield College, University of London, London E1, UK.
Qual Health Care. 2001 Sep;10 Suppl 1(Suppl 1):i29-33. doi: 10.1136/qhc.0100029...
There is a professional and legal consensus about the clinical duty to obtain informed consent from patients before treating them. This duty is a reflection of wider cultural values about the moral importance of respect for individual autonomy. Recent research has raised practical problems about obtaining informed consent. Some patients have cognitive and emotional problems with understanding clinical information and do not apparently wish to participate in making decisions about their treatment. This paper argues that such research does not undermine their potential to provide informed consent. Rather, sufficient resources are required to create better communication skills among clinicians and more effective educational materials for patients. Finally, cognitive and emotional inequality among patients is maintained to be a reflection of wider social and economic inequalities. Researchers who take the right to informed consent seriously should also address these.
在治疗患者之前,从患者那里获得知情同意的临床责任存在专业和法律上的共识。这一责任反映了关于尊重个人自主权的道德重要性的更广泛文化价值观。最近的研究提出了关于获得知情同意的实际问题。一些患者在理解临床信息方面存在认知和情感问题,并且显然不希望参与有关其治疗的决策。本文认为,此类研究并未削弱他们提供知情同意的潜力。相反,需要足够的资源来培养临床医生更好的沟通技巧,并为患者提供更有效的教育材料。最后,患者之间的认知和情感不平等被认为是更广泛的社会和经济不平等的反映。认真对待知情同意权的研究人员也应该解决这些问题。