Brighton and Sussex Medical School, University of Sussex, BSMS Teaching Building, Brighton BN1 9PX, UK.
Br J Anaesth. 2012 Jul;109(1):40-6. doi: 10.1093/bja/aes181.
Summary In law, consent allows the patient to determine what treatments they will accept or refuse. In this article, the common law of consent relating to anaesthesia is reviewed in order to highlight more recent changes to the standard of information provision and treatment of patients without capacity, and to form the basis of a critique of the current law. Practical and conceptual problems with the three core pillars of consent-voluntariness, capacity, and information-are analysed, along with the identification of logistical problems and contemporary theoretical challenges to the notion of patient autonomy as the basis of consent, concluding that 'assent' better describes the current legal position regarding treatment permission than 'consent'. In spite of this, the process of consent/assent is recognized as a major incentive towards data collection about patient-, operator-, and institution-specific risk, in order to better inform patients about the risks and benefits of treatment.
摘要 在法律中，同意允许患者决定接受或拒绝哪些治疗。本文回顾了与麻醉相关的普通法同意，以突出最近对无能力患者的信息提供和治疗标准的更改，并以此为基础对现行法律进行批判。分析了同意的三个核心支柱——自愿性、能力和信息——的实际和概念问题，以及对以患者自主性为同意基础的概念的逻辑问题和当代理论挑战，并得出结论，认为“同意”比“同意”更能描述当前关于治疗许可的法律地位。尽管如此，同意/同意的过程被认为是收集关于患者、操作人员和机构特定风险的数据的主要动力，以便更好地告知患者治疗的风险和益处。
