Suah Ashley, Angelos Peter
A general surgery resident at the University of Chicago.
The Linda Kohler Anderson Professor of Surgery and the chief of endocrine surgery at the University of Chicago, and serves as the associate director of the MacLean Center for Clinical Medical Ethics at the University of Chicago.
AMA J Ethics. 2018 May 1;20(5):425-430. doi: 10.1001/journalofethics.2018.20.5.ecas1-1805.
The precipitous and unexpected nature of trauma requires training health care practitioners to think and act quickly, according to the best medical interest of the patient. The urgency of treatment for trauma patients, who frequently have temporary alterations in their abilities to make autonomous and competent decisions, often results in consent for medically necessary treatment. Academic trauma centers use protocol-based management of injuries to facilitate their simultaneous evaluation by multiple clinicians and to avoid delays in treatment, ensuring that trauma patients receive the best possible care. In this article, we will discuss the issues of deferred informed consent and surgical education as they relate to trainees' graduated responsibility in the trauma bay.
创伤的突发性和意外性要求医护人员接受培训，以便能根据患者的最佳医疗利益迅速思考并采取行动。创伤患者常常在自主做出合理决策的能力方面出现暂时改变，其治疗的紧迫性往往导致对必要医疗治疗的同意。学术性创伤中心采用基于方案的损伤管理方法，以便多名临床医生能同时对患者进行评估，并避免治疗延误，确保创伤患者得到尽可能最佳的护理。在本文中，我们将讨论延迟知情同意和外科教育问题，因为它们与实习医生在创伤治疗区逐渐增加的责任相关。
