Hattori H, Salzberg S M, Kiang W P, Fujimiya T, Tejima Y, Furuno J
Department Legal Medicine, Yamaguchi University School of Medicine, Ube, Japan.
Soc Sci Med. 1991;32(9):1007-16. doi: 10.1016/0277-9536(91)90158-9.
A questionnaire survey concerning informed consent was administered among Japanese physicians in Yamaguchi prefecture. The survey results showed that even though these Japanese physicians are willing to give their patients sufficient information to obtain informed consent, the discretion of the physician to provide information is still prevalent. The survey also revealed that Japanese physicians believe that information regarding the treatment to be administrated should be fully disclosed both in case when the treatment is still experimental and when it is established among specialists. Finally, the survey showed that despite the liberal attitude of the Japanese physicians toward informed consent, they are reluctant to make medical records accessible to the patients. It was found that when Japanese physicians were faced with special cases such as prior to administering high-risk diagnostic procedures, prior to disclosing the presence of cancer in their patients, or when faced with patients unwilling to receive treatment, the involvement of the patient's family members in the decision-making process was preferred so as not to aggravate the patient's emotional anxiety. With respect to cancer patients, the survey suggested that many Japanese physicians believe that cancer operations performed without informed consent from the patient should be legal. Finally, the survey concluded that, although the concept of individualized informed consent has been generally accepted among physicians, the involvement of family members in the decision-making process and a conservative attitude toward disclosure of information are still prevalent in Japan.
对山口县的日本医生进行了一项关于知情同意的问卷调查。调查结果显示，尽管这些日本医生愿意向患者提供足够的信息以获得知情同意，但医生在提供信息方面的自由裁量权仍然普遍存在。调查还显示，日本医生认为，无论是在治疗仍处于实验阶段还是在专家中已确立的情况下，都应充分披露有关即将进行的治疗的信息。最后，调查表明，尽管日本医生对知情同意持开明态度，但他们不愿让患者查阅病历。研究发现，当日本医生面对特殊情况时，如在进行高风险诊断程序之前、在向患者披露癌症存在之前，或面对不愿接受治疗的患者时，他们更倾向于让患者家属参与决策过程，以免加重患者的情绪焦虑。对于癌症患者，调查表明许多日本医生认为未经患者知情同意进行的癌症手术应该是合法的。最后，调查得出结论，尽管个性化知情同意的概念在医生中已普遍被接受，但在日本，家属参与决策过程以及对信息披露持保守态度仍然普遍存在。
