Ataç Adnan, Guven Tolga, Uçar Muharrem, Kir Tayfun
Department of History of Medicine and Medical Ethics, Gulhane Military Medical Academy, 06018 Etlik, Ankara, Turkey.
Mil Med. 2005 Jul;170(7):566-71. doi: 10.7205/milmed.170.7.566.
To examine the opinions and the self-reported behaviors of physicians regarding the issues of informed consent and refusing treatment.
This study was performed between July and September 2003, with 51 physicians selected by simple random sampling. The data were collected by using a questionnaire.
A training hospital of medicine faculty.
Fifty-one clinicians working in the branches of internal medicine and surgery.
Although the majority (80.4%) of the participants think that information about diagnosis and treatment should always be disclosed to patients, 60.8% reported that they always disclose information about the diagnosis and 49% did the same for information about treatment. A total of 84.3% think that patients' consent should always be obtained before diagnostic and therapeutic procedures, whereas 47% reported that they always obtain consent in their clinical practice. It was also seen that physicians have doubts concerning the comprehension of the information they disclose to their patients. In addition, most (86.3%) of the participants think that a competent patient always has the right to refuse treatment, regardless of the disease and the outcomes.
Although opinions favoring the duties implied by informed consent are in the majority, these do not always reflect the behaviors in daily clinical practice, and there may be problems in carrying out the duties implied by the elements of informed consent. Some recommendations that could be beneficial in addressing these problems are presented at the end of the study.
探讨医生对于知情同意和拒绝治疗问题的看法及自我报告的行为。
本研究于2003年7月至9月进行,通过简单随机抽样选取了51名医生。采用问卷调查收集数据。
一所医学院的教学医院。
在内科和外科工作的51名临床医生。
尽管大多数(80.4%)参与者认为应始终向患者披露诊断和治疗信息,但60.8%报告他们总是披露诊断信息,49%对治疗信息也如此。共有84.3%认为在诊断和治疗程序前应始终获得患者同意,而47%报告他们在临床实践中总是获得同意。还发现医生对其向患者披露的信息的理解存在疑虑。此外,大多数(86.3%)参与者认为有行为能力的患者无论疾病和后果如何都始终有权拒绝治疗。
尽管赞成知情同意所隐含职责的观点占多数,但这些观点并不总是反映日常临床实践中的行为,在履行知情同意要素所隐含的职责方面可能存在问题。研究结尾提出了一些有助于解决这些问题的建议。