Marco Catherine A, Brenner Jay M, Kraus Chadd K, McGrath Norine A, Derse Arthur R
Department of Emergency Medicine, Wright State University Boonshoft School of Medicine, Dayton, OH.
Department of Emergency Medicine, SUNY-Upstate Medical University, Syracuse, NY.
Ann Emerg Med. 2017 Nov;70(5):696-703. doi: 10.1016/j.annemergmed.2017.04.015. Epub 2017 May 27.
Informed consent is an important component of emergency medical treatment. Most emergency department patients can provide informed consent for treatment upon arrival. Informed consent should also be obtained for emergency medical interventions that may entail significant risk. A related concept to informed consent is informed refusal of treatment. Patients may refuse emergency medical treatment during their evaluation and treatment. This article addresses important considerations for patients who refuse treatment, including case studies and discussion of definitions, epidemiology, assessment of decisional capacity, information delivery, medicolegal considerations, and alternative care plans.
知情同意是紧急医疗救治的重要组成部分。大多数急诊科患者在到达时能够对治疗给予知情同意。对于可能存在重大风险的紧急医疗干预措施，也应获得知情同意。与知情同意相关的一个概念是知情拒绝治疗。患者在评估和治疗过程中可能拒绝紧急医疗救治。本文探讨了患者拒绝治疗时的重要考量因素，包括案例分析以及对定义、流行病学、决策能力评估、信息传达、法医学考量和替代护理计划的讨论。
