Heywood Rob
Law Department, Sheffield Hallam University, UK.
Med Law Int. 2005;7(2):93-112. doi: 10.1177/096853320500700201.
This article examines the debate surrounding the challenging concept of informed consent. It argues whilst the English courts have effectively excluded the use of the tort of battery as an appropriate mechanism for protecting a patient's right to self-determination, they have left the law in a state of flux due to the uncertainties associated with categorising similar claims within negligence where the onus is on risk disclosure. This confusion may stem firstly from the fact that medical practitioners are unsure exactly which risks to disclose, and secondly, from the way in which both doctors and patients perceive the consent process. The paper suggests this disorder may be having a detrimental effect on medical practice as medical practitioners are taking it upon themselves to disclose excessive information, which patient's may not want or need. A suggestion is also made that in these situations, in order that the law truly respects self-determination, consideration must be given to the patient's desire to waive their right to informed consent.
本文探讨了围绕知情同意这一具有挑战性概念的争论。文章认为,尽管英国法院实际上已排除将殴打侵权行为作为保护患者自决权的适当机制,但由于在过失侵权中将类似索赔归类存在不确定性(其中风险披露的责任重大),导致法律处于不断变化的状态。这种混乱可能首先源于医生不确定究竟要披露哪些风险,其次源于医生和患者对同意过程的认知方式。该论文指出,这种混乱可能正在对医疗实践产生不利影响,因为医生自行决定披露过多患者可能不需要或不想要的信息。文中还提出,在这些情况下,为了使法律真正尊重自决权,必须考虑患者放弃其知情同意权的意愿。