Lupton Martin
Chelsea and Westminster Hospital and Imperial College, London, UK.
Curr Opin Obstet Gynecol. 2005 Dec;17(6):601-4. doi: 10.1097/01.gco.0000191900.61697.74.
The National Health Service Litigation Authority has issued a warning about the process of asking a patient for their consent prior to a medical procedure. This warning was issued in the light of the case of Chester v. Afshar. For the first time in English law the courts have appeared to state that failure to give a patient adequate information about a procedure is negligent per se. This article briefly examines the history of consent since the famous case of Bolam and reviews the recent legal commentary on the case of Chester. It will also consider a proposed solution to the question 'What is adequate information?'
The medicolegal literature traces the change in the legal test used to determine whether a patient has been adequately informed. It charts the evolution of a 'prudent patient' test and suggests ways in which medical practitioners might adequately fulfil their duty to inform patients properly.
Since the case of Chester v. Afshar it has become harder for a doctor to escape a charge of negligence if they have given inadequate information at the time of asking a patient for their consent to undergo a medical procedure. It is in everyone's interests - doctor and patient - to make the process of consent transparent and to an agreed national standard.
综述目的:英国国家医疗服务诉讼局就医疗程序前征求患者同意的过程发出了警告。该警告是鉴于切斯特诉阿夫沙尔案而发布的。在英国法律中,法院首次似乎表明,未向患者提供有关程序的充分信息本身即构成过失。本文简要回顾了自著名的博勒姆案以来的同意史,并审视了近期关于切斯特案的法律评论。它还将考虑对“什么是充分信息?”这一问题的一个提议解决方案。
近期发现:法医学文献追溯了用于确定患者是否得到充分告知的法律测试的变化。它描绘了“审慎患者”测试的演变,并提出了医生可如何充分履行其向患者恰当告知义务的方法。
总结:自切斯特诉阿夫沙尔案以来,如果医生在征求患者同意接受医疗程序时提供的信息不足,就更难逃避过失指控。使同意过程透明并符合商定的国家标准符合每个人的利益,无论是医生还是患者。