日本成人对成人活体肝移植中的三种自愿同意模式。

Three patterns of voluntary consent in the case of adult-to-adult living related liver transplantation in Japan.

作者信息

Fujita M, Slingsby B T, Akabayashi A

机构信息

Biomedical Ethics, School of Public Health, Kyoto University Graduate School of Medicine, Kyoto, Japan.

出版信息

Transplant Proc. 2004 Jun;36(5):1425-8. doi: 10.1016/j.transproceed.2004.04.088.

DOI:10.1016/j.transproceed.2004.04.088

PMID:15251350

Abstract

To elucidate the psychosocial aspects of the donors' decisions to engage in adult-to-adult living related liver transplantation, we interviewed a total of five institutional ethics committee members who had experience with reassessing informed consent prior to surgery. Qualitative analysis revealed several nuances of voluntary consent consisting of three patterns: "unconditional consent" is consent from the bottom of one's heart to save a family member's life; "pressured consent" describes a donor who feels implicit pressure to donate despite fear; and "ulterior-motivated consent" defines a donor who has a hidden motive. This study diverges from previous work in that it employs a qualitative approach to deconstructing the psychosocial intricacies of the informed consent process in adult-to-adult LRLT. This initial study raises several questions on the meaning of voluntary informed consent in adult-to-adult living related liver transplantation.

摘要

为了阐明捐赠者决定进行成人对成人活体肝移植的社会心理因素，我们共采访了五位在手术前重新评估知情同意书方面有经验的机构伦理委员会成员。定性分析揭示了自愿同意的几个细微差别，包括三种模式：“无条件同意”是指发自内心地同意拯救家庭成员的生命；“被迫同意”描述的是尽管心存恐惧但仍感到有隐性捐赠压力的捐赠者；“别有用心的同意”指的是有隐藏动机的捐赠者。本研究与以往工作的不同之处在于，它采用定性方法来解构成人对成人活体肝移植知情同意过程中的社会心理复杂性。这项初步研究提出了几个关于成人对成人活体肝移植中自愿知情同意含义的问题。