Stein Joel, Brady Wagner Lynne C
Stroke/Neurology Rehabilitation Program, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Top Stroke Rehabil. 2006 Fall;13(4):42-6. doi: 10.1310/tsr1304-42.
Respect for patient autonomy and the need to have a comprehensive discussion of the risks and benefits of a medical intervention are two important issues involved in the process of obtaining informed consent. In dealing with individuals with aphasia, there may be particular challenges in balancing these two ethical imperatives. Although decision-making capacity may be preserved with aphasia, the patients' ability to fully participate in a dialogue regarding a proposed medical intervention is frequently impaired. We propose a process of enhancing informed consent for persons with aphasia while continuing to respect and enhance patient autonomy and the exercise of decision making for these patients. The use of a patient-selected "helper" during the informed consent process can improve the quality of the informed consent, while reserving final decision-making authority for the patient.
尊重患者自主权以及对医疗干预的风险和益处进行全面讨论的必要性，是获取知情同意过程中涉及的两个重要问题。在处理失语症患者时，平衡这两个道德要求可能会面临特殊挑战。尽管失语症患者可能保留决策能力，但他们充分参与关于拟议医疗干预的对话的能力常常受损。我们提出了一个增强失语症患者知情同意的过程，同时继续尊重并增强这些患者的自主权和决策行使。在知情同意过程中使用患者选择的“助手”可以提高知情同意的质量，同时为患者保留最终决策权。
