Hedgecoe Adam
Department of Sociology, University of Sussex, Falmer, Brighton BN1 6JQ, UK.
Soc Sci Med. 2005 Sep;61(6):1201-10. doi: 10.1016/j.socscimed.2005.01.021.
Sociological investigation of informed consent has generated rich and complex descriptions of the clinical encounter, often challenging the straightforward picture painted by medical ethicists. This paper builds on this work, drawing on ideas from the Sociology of Science and Technology, to explore informed consent issues surrounding the use of the drug Herceptin, widely cited as an example of a novel approach to drug development called pharmacogenetics. Drawing on qualitative semi-structured interviews with 25 UK-based breast cancer specialists, this paper explores Herceptin's disputed epistemological status, as an example of pharmacogenetics or as something out of the ordinary in terms of clinical practice. It considers how, in turn, this impacts on the way in which informed consent is sought and influenced by clinicians' desire to protect patients from possibly distressing test results. It highlights the flexible, contingent and context dependent nature of informed consent in the clinical setting.
对知情同意的社会学调查已经对临床接触进行了丰富而复杂的描述，这常常挑战医学伦理学家所描绘的简单图景。本文基于这项工作，借鉴科学技术社会学的观点，探讨围绕药物赫赛汀使用的知情同意问题。赫赛汀被广泛视为一种名为药物基因组学的新型药物研发方法的范例。本文通过对25位英国乳腺癌专家进行定性半结构化访谈，探讨了赫赛汀有争议的认识论地位，即作为药物基因组学的一个例子，或者在临床实践中属于不同寻常的事物。反过来，本文考虑了这如何影响寻求知情同意的方式，以及临床医生保护患者免受可能令人痛苦的检测结果影响的愿望如何对其产生影响。它强调了临床环境中知情同意的灵活、偶然和依赖情境的性质。
