Youngs Jonathan, Simmonds Joshua
Core Medical Training, St George's Hospital, London, UK.
Accident and Emergency, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Berkshire, UK.
J Med Ethics. 2016 Feb;42(2):95-9. doi: 10.1136/medethics-2015-102956. Epub 2015 Nov 24.
It is a tenet of the prevailing ethic in medicine that competent adults have the 'right to know' information necessary to make informed decisions about their healthcare. Whether there is a 'right not to know' unwanted information is more hotly debated. When deciding whether or not to override a competent adult's desire not to know his/her HIV result, a desire to respect patient autonomy can be seen to pull in both directions. We thus conclude that there is not a very strong presumption on the side of non-disclosure but rather the adult's interest in not knowing must be weighed against the potential harms and benefits of disclosure for both the individual and others. This does not, however, negate the fact that patients retain a right to refuse an HIV test and this is so even where issues of bodily integrity are not at stake. This implies that explicit consent should still be sought for HIV testing, at least where there is some possibility that the patient may refuse, or want more information, if given the chance.
医学领域现行伦理的一个原则是，有行为能力的成年人有权了解做出关于自身医疗保健的明智决策所需的信息。是否存在“不想知道”不必要信息的“权利”则更具争议性。在决定是否推翻有行为能力的成年人不想知道其艾滋病毒检测结果的意愿时，尊重患者自主权的愿望似乎会产生两种不同的倾向。因此，我们得出结论，在不披露信息这一方并没有非常有力的推定，相反，成年人不想知道的意愿必须与向个人及他人披露信息的潜在危害和益处相权衡。然而，这并不否定患者有权拒绝艾滋病毒检测这一事实，即便在不涉及身体完整性问题的情况下也是如此。这意味着，至少在患者有可能拒绝检测或如果有机会想要了解更多信息的情况下，仍应就艾滋病毒检测寻求明确同意。
