10AO1, Steve Biko Centre for Bioethics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 7 York Road, Parktown, Johannesburg 2193, South Africa.
Best Pract Res Clin Obstet Gynaecol. 2013 Feb;27(1):59-75. doi: 10.1016/j.bpobgyn.2012.08.007. Epub 2012 Sep 7.
For the clinician managing a woman who has been violated sexually, core values of compassion, understanding and concern for the woman's distress are essential. The nature of the violation itself places the woman in a uniquely dependant, anxious, vulnerable and exploitative state. Capacity, consent and confidentiality derive from the principle of autonomy. Informed consent entails a process of information sharing and decision making based on mutual respect and participation. Practitioners should have communication, listening and interpretative skills. One of the greatest challenges is the difficulty in ascertaining whether or not the woman truly understands and grasps the nature of her condition. There are many challenges to obtaining a valid consent in the real world. Information obtained from the woman could be shameful and embarrassing, but would be used in a court of law. She should be informed of the potential for breach of confidentiality. These issues are explored and examples of practical application of the relevant themes are given from the England and Wales jurisdiction.
对于管理遭受性侵的女性的临床医生来说，同情、理解和关心女性痛苦的核心价值观至关重要。侵犯行为本身使女性处于一种独特的依赖、焦虑、脆弱和易受剥削的状态。能力、同意和保密性源自自主性原则。知情同意需要基于相互尊重和参与的信息共享和决策过程。从业者应该具备沟通、倾听和解释技能。最大的挑战之一是难以确定女性是否真正理解和掌握自己的病情。在现实世界中，获得有效同意存在许多挑战。从女性那里获得的信息可能是可耻和尴尬的，但将在法庭上使用。应告知她可能违反保密规定的情况。这些问题进行了探讨，并从英格兰和威尔士司法管辖区给出了相关主题的实际应用示例。
