Schachter Madeleine, Fins Joseph J
Division of Medical Ethics, New York Presbyterian-Weill Cornell Medical Center, New York, New York 10021 USA.
Oncologist. 2008 Oct;13(10):1109-13. doi: 10.1634/theoncologist.2008-0101. Epub 2008 Oct 10.
Informed consent traditionally has been viewed as a safeguard for the protection of patients' decisional autonomy. While informed consent is a critical means for the protection of the patient's dominion over the integrity of his body, exclusive consideration of the doctrine as a safeguard for patients eclipses the doctrine's significant benefits for the therapeutic endeavor. Undertaking a thorough informed consent process helps the physician avoid the unilateral burdens of paternalism; furthers compliance with the doctor's legal obligations, ethical duties, and clinical responsibilities; and, as importantly, enhances the collaborative treatment enterprise. When informed consent is viewed narrowly and solely as a protective device for patients' rights, the physician may be less likely to engage the patient in ongoing discussions. Important opportunities may be missed to elicit additional clinical information, assess psychosocial concerns, and reiterate the commitment to collaboration and patient autonomy.
传统上，知情同意被视为保护患者决策自主权的一种保障措施。虽然知情同意是保护患者对其身体完整性控制权的关键手段，但仅将该原则视为患者的保障措施，就掩盖了该原则对治疗努力的重大益处。进行全面的知情同意过程有助于医生避免家长式作风的单方面负担；进一步遵守医生的法律义务、道德职责和临床责任；同样重要的是，加强合作性治疗工作。当狭义地且仅将知情同意视为患者权利的保护手段时，医生可能不太愿意与患者进行持续的讨论。可能会错过获取更多临床信息、评估心理社会问题以及重申对合作和患者自主权承诺的重要机会。
