Moulton Benjamin, King Jaime S
Health Law at Harvard School of Public Health, MA, USA.
J Law Med Ethics. 2010 Spring;38(1):85-97. doi: 10.1111/j.1748-720X.2010.00469.x.
Clinical evidence suggests that many patients undergo surgery that they would decline if fully informed. Failure to communicate the relevant risks, benefits, and alternatives of a procedure violates medical ethics and wastes medical resources. Integrating shared decision-making, a method of communication between provider and patient, into medical decisions can satisfy physicians' ethical obligations and reduce unwanted procedures. This article proposes a three-step process for implementing a nationwide practice of shared decision-making: (1) create model integration programs; (2) provide legal incentives to ease the transition; and (3) incorporate shared decision-making into medical necessity determinations.
临床证据表明，许多患者接受了如果充分了解情况就会拒绝的手术。未能告知手术的相关风险、益处和替代方案既违反医学伦理，又浪费医疗资源。将共享决策（一种医患沟通方法）纳入医疗决策，可以履行医生的伦理义务并减少不必要的手术。本文提出了一个在全国范围内实施共享决策实践的三步流程：（1）创建示范整合项目；（2）提供法律激励措施以促进转型；（3）将共享决策纳入医疗必要性判定。
