Knowles D
Department of Philosophy, University of Glasgow, Glasgow, G12 8QQ, UK.
J Appl Philos. 2001;18(3):215-27. doi: 10.1111/1468-5930.00190.
Parents of children who died following complex heart surgery have recently discovered that organs were removed and retained in post-mortem investigations to which they consented. It has been established that many of these parents did not give informed consent to the retention of organs. The Bristol Royal Infirmary Inquiry which examined these practices drafted codes of practice to govern future post-mortem activities. It is argued that these codes of practice may be onerous to some parents, yet effectively disbar them from dissenting to their application whilst they might otherwise agree to the post-mortem removal and retention of organs for purposes of medical audit, research or training. This consequence arises from employing an over-rigorous concept of informed consent in the immediate circumstances of bereavement. That concept is discussed in detail. An alternative proposal is canvassed which improves on the status quo but does not impose a practice of consent which may be burdensome and distressing to many.
接受复杂心脏手术后死亡儿童的家长最近发现,在他们同意的尸检调查中,器官被摘除并留存了下来。现已确定,许多家长并未对器官留存给予知情同意。对这些做法进行调查的布里斯托尔皇家医院调查委员会起草了行为准则,以规范未来的尸检活动。有人认为,这些行为准则对一些家长来说可能过于繁琐,但实际上使他们无法对其适用表示异议,而在其他情况下,他们可能会同意为医学审计、研究或培训目的进行尸检摘除和留存器官。这种后果是由于在丧亲的紧迫情况下采用了过于严格的知情同意概念。文中对该概念进行了详细讨论。还探讨了另一种提议,该提议改进了现状,但没有强制实行一种可能给许多人带来负担和痛苦的同意做法。