Peters Carol
Legal Health, Whangaparaoa 0943, Auckland, New Zealand.
N Z Med J. 2009 Aug 7;122(1300):50-9.
This research sought to (1) clarify the law relating to consent to medical treatment; (2) assess healthcare providers' knowledge of that law; (3) determine the extent of risk of legal sanctions; and (4) make recommendations to address any knowledge gap identified.
A questionnaire was distributed to healthcare providers in six pre-selected District Health Board areas. Participation was voluntary and open to all healthcare providers whose work requires involvement in the consent process. The Health and Disability Commissioner's Office identified 19 questions all healthcare providers are expected to know (referred to as "expected knowledge" questions). The effect that participants' clinical experience, occupation and training had on knowledge of the law was assessed. 144 questionnaires were completed.
Only one "expected knowledge" question was answered universally correct. Error rates for the other 18 expected knowledge questions varied between 1.4% to 75.4%. "Don't know" responses varied between 0% to 28.2%. The respondents' clinical experience and occupation had no statistically significant effect upon reported knowledge of the law. Respondents who had received training on consent issues achieved statistically significant better results than untrained respondents in respect of the expected knowledge questions, although the magnitude of difference was small. Only 51.4% of respondents had received any form of training on consent to medical treatment issues.
This research indicates poor overall knowledge of some key areas of the law relating to consent to medical treatment. Failure to redress the current knowledge levels may result in negative outcomes for patients and healthcare providers including compromised patient autonomy, poorer patient health, and potential legal liability for non-compliant healthcare providers. Improved access to the law is recommended together with legislative amendments where the law is identified as unclear.
本研究旨在（1）阐明与医疗同意相关的法律；（2）评估医疗服务提供者对该法律的了解程度；（3）确定面临法律制裁的风险程度；（4）针对所发现的知识差距提出建议。
向六个预先选定的地区卫生委员会区域的医疗服务提供者发放了问卷。参与是自愿的，面向所有工作需要参与同意过程的医疗服务提供者。健康与残疾专员办公室确定了所有医疗服务提供者都应知晓的19个问题（称为“预期知识”问题）。评估了参与者的临床经验、职业和培训对法律知识的影响。共完成了144份问卷。
只有一个“预期知识”问题的回答全部正确。其他18个预期知识问题的错误率在1.4%至75.4%之间。“不知道”的回答比例在0%至28.2%之间。受访者的临床经验和职业对报告的法律知识没有统计学上的显著影响。在预期知识问题方面，接受过同意问题培训的受访者的成绩在统计学上显著优于未受过培训的受访者，尽管差异幅度较小。只有51.4%的受访者接受过任何形式的医疗同意问题培训。
本研究表明，医疗服务提供者对与医疗同意相关法律的一些关键领域的总体了解较差。未能纠正当前的知识水平可能会给患者和医疗服务提供者带来负面后果，包括损害患者自主权、患者健康状况变差以及不合规的医疗服务提供者可能承担法律责任。建议改善对法律的获取途径，并在法律被认为不明确的情况下进行立法修订。
