Jones Kevin B
Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242, USA.
Iowa Orthop J. 2007;27:115-20.
The moment of decision to proceed with surgical intervention is charged with some of the deepest uncertainties in medicine, but has long been cloaked under the confidence asserted by the traditionally custodial surgeon. This paper reviews the history and ethical basis for informed surgical consent. Beginning with theoretical foundations and the changing ethics of medical decision making since the ancient Greeks, it then reviews how the stage was set for informed consent by technological breakthroughs that made surgical interventions tolerable and acceptably safe. Finally, the legal generation of the doctrine of informed consent is reviewed and the current state of disclosure, shared decision-making, and uncertainty explored.
决定进行手术干预的时刻充满了医学中一些最深层次的不确定性，但长期以来一直被传统主导手术的外科医生所宣称的自信所掩盖。本文回顾了知情手术同意的历史和伦理基础。从理论基础以及自希腊人以来医学决策伦理的变化开始，接着回顾了技术突破如何为知情同意奠定了基础，这些技术突破使手术干预变得可以忍受且具有可接受的安全性。最后，回顾了知情同意原则的法律产生过程，并探讨了目前信息披露、共同决策和不确定性的状况。
