Siewiera Jacek, Trnka Jakub, Kübler Andrzej
Department of Anaesthesiology and Intensive Therapy, 4th Military Hospital, Wrocław, Poland.
Anaesthesiol Intensive Ther. 2013 Jan-Mar;45(1):44-8. doi: 10.5603/AIT.2013.0010.
In contemporary clinical practice, the issue of requesting patient consent to perform therapeutic treatment plays an important role. The conscious consent of a patient as an expression of one's will greatly strengthens the legality of medical procedures performed by a physician, regardless of the medical field. However, obtaining consent to treatment in the intensive care unit (ICU) often poses enormous difficulties in daily clinical work, and has in recent decades been the cause of much dispute between doctors and lawyers. The correct interpretation of the provisions under the relevant laws determines the safety and comfort of the medical practice in the ICU. This study compared the current rules of normative acts of Polish common law relating to medical practice in intensive care units and issued on the basis of the judgments of the common court of law over the past ten years. On the basis of those provisions, the authors conclude that the patient should be informed by the anaesthesiologist during the visit as to the possibility of postoperative therapy in the ICU. The extent of such information depends on the likelihood of having treatment in the ICU. The consent of the patient for hospitalisation in the ICU should be mandatory in the case of treatments which are very likely to necessitate such hospitalisation. This concerns especially cardiac surgery, neurosurgery and treatments for patients with a significant burden of disease. The authors of this study propose that an information and consent form to undergo treatment in the intensive care unit should be included within the anaesthesia consent form.
在当代临床实践中，要求患者同意进行治疗性治疗这一问题发挥着重要作用。患者的自主同意作为个人意愿的一种表达，极大地增强了医生所实施医疗程序的合法性，无论医疗领域如何。然而，在重症监护病房（ICU）获取治疗同意在日常临床工作中常常带来巨大困难，并且在近几十年来一直是医生与律师之间诸多争议的根源。对相关法律条款的正确解读决定了ICU医疗实践的安全性与舒适性。本研究比较了波兰普通法中与重症监护病房医疗实践相关的规范性行为的现行规则，这些规则是基于过去十年普通法院的判决发布的。基于这些条款，作者得出结论，麻醉医生在查房期间应告知患者在ICU进行术后治疗的可能性。此类信息的范围取决于在ICU接受治疗的可能性。对于极有可能需要入住ICU的治疗，患者对入住ICU的同意应是强制性的。这尤其涉及心脏手术、神经外科手术以及患有严重疾病患者的治疗。本研究的作者提议，重症监护病房治疗的信息及同意书应包含在麻醉同意书内。
