School of Medicine, University of Michigan, Ann Arbor, MI, USA.
Int J Clin Pract. 2011 Dec;65(12):1214-7. doi: 10.1111/j.1742-1241.2011.02762.x.
Contracts with patients have become increasingly common in clinical practice and the medical literature. These include behavioral contracts for managing “difficult patients” , opioid contracts, suicide prevention contracts, and healthy living contracts. Some physician practices have even asked patients to sign contracts promising not to litigate or post defamatory comments on the Internet. Despite widespread adoption, few have stopped to consider the potential risks and ethical concerns with using these documents. This perspective will describe how patient contracts are ultimately about power and control, and if not used carefully could damage the patient-physician relationship.
在临床实践和医学文献中，患者合同变得越来越普遍。这些合同包括管理“难缠患者”的行为合同、阿片类药物合同、自杀预防合同和健康生活合同。一些医生诊所甚至要求患者签署合同，承诺不起诉或在互联网上发布诽谤性评论。尽管这些合同已被广泛采用，但很少有人停下来考虑使用这些文件的潜在风险和道德问题。本文观点将描述患者合同最终是关于权力和控制的，如果使用不当，可能会损害医患关系。
