Institut für Moraltheologie, Faculty of Catholic Theology, University of Bochum, Bochum, Germany.
J Med Ethics. 2010 Jun;36(6):349-52. doi: 10.1136/jme.2009.033282. Epub 2010 May 28.
The medical decision-making process is currently in flux. Decisions are no longer made entirely at the physician's discretion: patients are becoming more and more involved in the process. There is a great deal of discussion about the ideal of 'informed consent', that is that diagnostic and therapeutic decisions should be made based on an interaction between physician and patient. This means that patients are informed about the advantages and disadvantages of a treatment as well as alternatives to the treatment; then, based on this information they can decide whether or not they want to undergo the treatment. However, recent studies show that the realisation of the ideal of 'shared decision-making' faces a number of difficulties related to the fact that patients are not provided with complete and accurate information. Using the example of breast cancer screening, this article examines the question of whether, in light of these difficulties, the ideal of informed decision-making is only an illusion or whether concrete steps can be taken towards the realisation of this ideal.
医学决策过程正在发生变化。决策不再完全由医生自行决定：患者越来越多地参与到决策过程中。关于“知情同意”的理想存在大量讨论，即诊断和治疗决策应基于医生和患者之间的互动。这意味着患者应该了解治疗的优缺点以及治疗的替代方案；然后，根据这些信息，他们可以决定是否接受治疗。然而，最近的研究表明，实现“共同决策”的理想面临着一些困难，这些困难与患者没有得到完整和准确的信息有关。本文以乳腺癌筛查为例，探讨了在这些困难面前，知情决策的理想是否只是一种幻想，或者是否可以朝着实现这一理想迈出具体的步伐。
