Younger C W E, Douglas C, Warren-Forward H
The University of Newcastle, University Drive, Callaghan, NSW 2308 Australia.
Radiography (Lond). 2018 May;24(2):146-150. doi: 10.1016/j.radi.2017.12.002. Epub 2017 Dec 20.
Autonomy is a fundamental patient right for ethical practice, and informed consent is the mechanism by which health care professionals ensure this right has been respected. The ethical notion of informed consent has evolved alongside legal developments. Under Australian law, a provider who fails to disclose risk may be found to be in breach of a duty of disclosure, potentially facing legal consequences if the patient experiences harm that is attributable to an undisclosed risk. These consequences may include the common law tort of negligence. Ionising radiation, in the form of a medical imaging examination, has the potential to cause harm. However, stochastic effects cannot be attributable to a specific ionising radiation event. What then is the role of the Australian medical imaging service provider in disclosing ionising radiation risk?
The ethical and legal principles of informed consent, and the duty of information provision to the patient are investigated. These general principles are then applied to the specific and unusual case of ionising radiation, and what responsibilities apply to the medical imaging provider. Finally, the legal, professional and ethical duties of the radiographer to disclose information to their patients are investigated.
Australian law is unclear as to whether a radiographer has a common law responsibility to disclose radiation risk. There is ambiguity as to whether stochastic ionising radiation risk could be considered a legal disclosure responsibility.
While it is unlikely that not disclosing risk will have medicolegal consequences, doing so represents sound ethical practice.
自主是符合伦理规范的医疗行为中一项基本的患者权利,而知情同意是医疗保健专业人员确保这项权利得到尊重的机制。知情同意的伦理概念是随着法律发展而演变的。根据澳大利亚法律,未能披露风险的提供者可能被认定违反披露义务,如果患者因未披露的风险而受到伤害,可能会面临法律后果。这些后果可能包括普通法中的过失侵权行为。医学影像检查形式的电离辐射有可能造成伤害。然而,随机效应不能归因于特定的电离辐射事件。那么,澳大利亚医学影像服务提供者在披露电离辐射风险方面的作用是什么呢?
研究知情同意的伦理和法律原则以及向患者提供信息的义务。然后将这些一般原则应用于电离辐射这一特殊且不寻常的情况,以及医学影像提供者应承担哪些责任。最后,研究放射技师向患者披露信息的法律、专业和伦理义务。
澳大利亚法律对于放射技师是否有普通法规定的披露辐射风险的责任并不明确。对于随机电离辐射风险是否可被视为法律披露责任存在模糊性。
虽然不披露风险不太可能产生法医学后果,但这样做代表了良好的伦理实践。