Salinas Rodrigo R, Echeverría B Carlos, Arriagada U Anamaría, Goic G Alejandro, Quintana V Carlos, Rojas O Alberto, Serani M Alejandro, Taboada R Paulina, Vacarezza Y Ricardo
Facultad de Medicina, Universidad de Chile, Santiago, Chile.
Hospital Naval "Almirante Nef", Viña del Mar, Chile.
Rev Med Chil. 2017 Sep;145(9):1198-1202. doi: 10.4067/s0034-98872017000901198.
During the last years, bioethical discussion has highlighted the role of the patients' autonomy, being informed consent its particular expression, about decisions that they should make about their own health. The Hippocratic tradition, the deontological positions of the Geneva Declaration of the World Medical Association and numerous codes of ethics in various countries, require that the physician, above all, should ensure patients' health. In this context the discussion on pros and cons for the so-called "therapeutic privilege" are discussed. The "therapeutic privilege" refers to the withholding of information by the clinician during the consent process in the belief that disclosure of this information would lead to harm or suffering of the patient. The circumstances and conditions in which this privilege can become valid are discussed. Special reference is made in order to respect multiculturalism and to the possibility of obtaining advice from health care ethics committees. The role of prudence in the doctor-patient relation must be highlighted. Disclosure of information should be subordinated and oriented to the integral well-being of the patient.
在过去几年中，生物伦理讨论突出了患者自主权的作用，知情同意是其关于自身健康决策的具体表现形式。希波克拉底传统、世界医学协会《日内瓦宣言》的道义立场以及各国众多伦理准则都要求医生首先应确保患者的健康。在此背景下，人们讨论了所谓“治疗特权”的利弊。“治疗特权”指临床医生在同意过程中隐瞒信息，认为披露此信息会给患者带来伤害或痛苦。文中讨论了该特权生效的情况和条件。特别提及了尊重多元文化主义以及向医疗保健伦理委员会寻求建议的可能性。必须强调审慎在医患关系中的作用。信息披露应服从并以患者的整体福祉为导向。
