Wright Linda, MacRae Susan, Gordon Debra, Elliot Esther, Dixon David, Abbey Susan, Richardson Robert
Multi Organ Transplant Programme, Toronto General Hospital, University Health Network, Ontario, Canada.
Semin Dial. 2002 May-Jun;15(3):202-6. doi: 10.1046/j.1525-139x.2002.00541.x.
Kidney transplantation from living donors is generally a safe, effective form of renal replacement therapy. When evaluating potential living donors and their intended recipients, a careful assessment process is followed in order to ensure that ethical standards are upheld. During this assessment, important medical information with serious consequences, which was not being sought as part of the donor/recipient evaluation, may be discovered. The information may or may not be relevant to the decision to donate. However, such a discovery raises the difficult questions of whether or not there is an obligation to disclose the information, to whom does the information belong, and what process should be used to resolve the issue? We present a case that forced us to confront these questions and raised issues of truth telling, autonomy, paternalism, confidentiality, and the nature of the relationship between patients and health care professionals.
活体供肾移植通常是一种安全、有效的肾脏替代治疗方式。在评估潜在的活体供者及其预期受者时，会遵循一个细致的评估流程，以确保坚持伦理标准。在这个评估过程中，可能会发现一些具有严重后果的重要医学信息，而这些信息并非作为供者/受者评估的一部分来收集。该信息可能与捐赠决定相关，也可能无关。然而，这样的发现引发了一些难题，即是否有义务披露该信息、该信息属于谁，以及应采用何种程序来解决这个问题？我们呈现一个案例，该案例迫使我们直面这些问题，并引发了关于讲真话、自主权、家长式作风、保密以及患者与医护人员之间关系本质的问题。
