Lopez-Nicolas Manuel, Falcón Maria, Perez-Carceles Maria Dolores, Osuna Eduardo, Luna Aurelio
Department of Forensic and Legal Medicine, University of Murcia, Medical School, Spain.
Int Dent J. 2007 Jun;57(3):168-72. doi: 10.1111/j.1875-595x.2007.tb00120.x.
With the introduction of informed consent in dental practice in Spain during the last ten years activity has been focused on avoiding complaints rather than on giving adequate information to the patient. However, in the eyes of many professionals the document by which patients accept the cost or estimated charge of treatment is the equivalent of informed consent. Although Spanish law permits verbal consent in some cases (low risk therapeutic activities), some dentists interpret this law in a very broad way. The aim of this paper was to study the fulfilment of informed consent in relation to professional malpractice claims presented to the College of Dentists of the province of Murcia, south east Spain (regional professional association) during the last twelve years (n=52). Evaluation of the complaints pointed to adequate professional behaviour in 14 cases and malpractice in 38 cases (in 29 of which the treatment applied was technically correct but with inadequate information provided during the process, while nine cases represented technical errors). The written document of informed consent was absent in 40 cases, although the verbal information supplied was considered adequate in 14 cases. When the document of informed consent was present (12 cases) it was considered unsuitable, although adequately complemented by oral information.
在过去十年里,随着西班牙牙科实践中引入了知情同意制度,活动重点一直放在避免投诉上,而非向患者提供充分信息。然而,在许多专业人士看来,患者接受治疗费用或预估费用的文件就等同于知情同意。尽管西班牙法律在某些情况下(低风险治疗活动)允许口头同意,但一些牙医对该法律的解读非常宽泛。本文的目的是研究在过去十二年里(n = 52),提交给西班牙东南部穆尔西亚省牙医协会(地区专业协会)的与专业医疗事故索赔相关的知情同意情况。对投诉的评估表明,14起案件中专业行为得当,38起案件存在医疗事故(其中29起案件中所实施的治疗在技术上正确,但过程中提供的信息不足,而9起案件存在技术错误)。40起案件中没有知情同意的书面文件,不过14起案件中口头提供的信息被认为是充分的。当存在知情同意文件时(12起案件),尽管口头信息进行了充分补充,但该文件仍被认为不合适。