Raper Steven E, Sarwer David B
Department of Surgery, Hospital of the University of Pennsylvania and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA.
Surg Obes Relat Dis. 2008 Jan-Feb;4(1):60-8. doi: 10.1016/j.soard.2007.09.002. Epub 2007 Nov 5.
The goals of this article are to set forth the principles involved in obtaining informed consent in the context of bariatric surgery and to change the widely held perception that proper informed consent is an empty paper exercise. The ever-expanding use of bariatric procedures is associated with a profusion of data regarding the risks, benefits, and expected outcomes. It is now possible for physicians who perform bariatric surgery to know the reported data on the morbidity, mortality, and rehospitalization rates. Communicating this information to prospective patients is necessary for the process of informed consent.
A literature review of the work done in the areas of informed consent as it relates to bariatric procedures was performed to provide state-of-the-art information of this important topic.
Ethically, the concept of informed consent arises from the deep-rooted American respect for the independence of one's right to decide what is or is not done to one's body. Legally, the physician has two duties: to obtain consent and to provide information to allow the consent to be informed. The elements required for proper disclosure and consent have been codified by a variety of professional organizations.
Done properly, informed consent allows patients to have a more realistic expectation of the outcome and could also allow more effective participation in their own care. We conclude with possible directions for additional research, improvement of the consent process, and the inclusion of new technologies as they arise.
本文的目的是阐述在减肥手术背景下获得知情同意所涉及的原则，并改变人们普遍持有的一种观念，即适当的知情同意只是一纸空文。减肥手术的使用日益广泛，伴随着大量关于风险、益处和预期结果的数据。现在，实施减肥手术的医生有可能了解已报道的发病率、死亡率和再住院率数据。将这些信息传达给潜在患者是知情同意过程所必需的。
对与减肥手术相关的知情同意领域所做的工作进行文献综述，以提供关于这一重要主题的最新信息。
在伦理上，知情同意的概念源于美国人对个人决定对自己身体做或不做什么的权利独立性的根深蒂固的尊重。在法律上，医生有两项职责：获得同意并提供信息以使同意是知情的。适当披露和同意所需的要素已由各种专业组织编纂成法典。
如果操作得当，知情同意能让患者对结果有更现实的期望，也能让患者更有效地参与自身护理。我们最后提出了进一步研究、改进同意过程以及随着新技术出现将其纳入的可能方向。
