Knibbe Mare, Verkerk Marian
Department of Health Sciences, University Medical Center Groningen, University of Groningen, Expert Center Ethics of Care, 9700 RB, Groningen, The Netherlands.
Med Health Care Philos. 2010 May;13(2):149-56. doi: 10.1007/s11019-009-9226-7.
This paper contributes to the growing line of thought in bioethics that respect for autonomy should not be equated to the facilitation of individualistic self determination through standard requirements of informed consent in all healthcare contexts. The paper describes how in the context of donation for living related liver transplantation (LRLT) meaningful, responsible decision making is often embedded within family processes and its negotiation. We suggest that good donor risk communication in families promote "conscientious autonomy" and "reflective trust". From this, the paper offers the suggestion that transplant teams and other relevant professionals have to broaden their role and responsibility for risk communication beyond proper disclosure by addressing the impact of varied psychosocial conditions on risk interpretation and assessment for potential donors and family stakeholders. In conclusion, we suggest further research questions on how professional responsibility and role-taking in risk communication should be morally understood.
本文对生物伦理学中日益增长的一种思想做出了贡献，即尊重自主性不应等同于在所有医疗保健环境中通过知情同意的标准要求来促进个人主义的自我决定。本文描述了在亲属活体肝移植（LRLT）捐赠的背景下，有意义、负责任的决策通常是如何融入家庭过程及其协商之中的。我们认为，在家庭中进行良好的供体风险沟通可促进“尽责的自主性”和“反思性信任”。据此，本文提出建议，移植团队和其他相关专业人员必须通过解决各种社会心理状况对潜在供体和家庭利益相关者的风险解读和评估的影响，来扩大其在风险沟通方面的作用和责任，而不仅仅是进行适当的信息披露。总之，我们提出了关于如何从道德层面理解风险沟通中的专业责任和角色担当的进一步研究问题。
