Neuro Oncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta Milano, Via Celoria, 11, 20133 Milan, Italy.
Neurol Sci. 2011 Nov;32 Suppl 2:S221-4. doi: 10.1007/s10072-011-0791-1.
Informed consent is often talked about in an abstract manner, as if consent and information necessarily have to go together, and almost as if consent is "naturally" the quintessence of a good professional relationship in modern medicine. The United States is considered as the place of origin of informed consent. In Italy the concept of informed consent can be found for the first time in the 1990s. Informed consent is based on the principles of autonomy and benefit, on awareness and information. Already at the moment of the diagnosis, in addition to motor deficits, focal cognitive deficits are often present. It is important for the doctor to consider and evaluate the actual ability to comprehend and process the clinical situation on the part of the patient. At the Neuro-Oncology Division of the Carlo Besta Neurological Institute of Milan, we sought to analyse how and to what extent the brain tumour alters and conditions cognitive functionality, and hence the ability to process, comprehend and retain information during a diagnostic communication, and whether and how this moment is influenced by the presence of any global or specific cognitive deficits. Preliminary and performed on a numerically limited sample, 30 patients out of 42, in a specific neuropsychological survey, display cognitive attention and memory deficits despite achieving an adequate score on a global cognitive assessment. The physician's attention to the cognitive faculties of a patient to whom a pathological condition and a therapeutic approach are being presented is fundamental.
知情同意通常以抽象的方式被讨论，似乎同意和信息必然要一起出现，而且几乎好像同意是现代医学中良好专业关系的“本质”。美国被认为是知情同意的起源地。在意大利，知情同意的概念最早可以追溯到 20 世纪 90 年代。知情同意基于自主和受益、意识和信息的原则。在诊断的那一刻，除了运动缺陷外，通常还存在局灶性认知缺陷。医生考虑和评估患者实际理解和处理临床情况的能力非常重要。在米兰的 Carlo Besta 神经学研究所的神经肿瘤学部门，我们试图分析脑肿瘤如何以及在何种程度上改变和影响认知功能，从而影响在诊断沟通中处理、理解和保留信息的能力，以及这一时刻是否以及如何受到任何全局或特定认知缺陷的影响。在一项特定的神经心理学调查中，对 42 名患者中的 30 名进行了初步和有限的数字样本分析，这些患者尽管在整体认知评估中取得了足够的分数，但存在认知注意力和记忆力缺陷。医生关注向患者呈现病理状况和治疗方法的认知能力至关重要。
