Leonard C G, Toner J G
ST7 in ENT, LLM Medical Law and Ethics and MA Medical Ethics and Law, Department of Otorhinolaryngology - Head and Neck Surgery, Royal Victoria Hospital, Belfast.
Ulster Med J. 2019 Jan;88(1):1-3. Epub 2019 Jan 22.
Since the landmark case of Montgomery v Lanarkshire in 2015, much has been written in medical press regarding the implications for medical practice. The moral duty - varied though it has been over this time, has been discussed since the earliest days of the medical profession. The law has sought to define this duty in response to changes in society, and the nature of the relationship between doctor and patient. The moral and legal duty are intrinsically linked, but the latter must surely follow the former for "the law has little to do with morally required forms of communication in the clinic and in the research environment." The common law nature of this process has resulted in an inconsistent and often tortuous path as societal standards have shifted. Accordingly, the ultimate definition of the legal doctrine, "informed consent," has changed since its relatively recent entry into the medicolegal vocabulary. These parallel shifts in the legal and moral duty to disclose risk have resulted in a confusing melee of evidence and recommendations for clinicians. We address the development of the law of "informed consent," as the legal mirror of the moral duty upon a clinician to disclose risk to their patient.
自2015年蒙哥马利诉拉纳克郡这一具有里程碑意义的案件以来，医学刊物上发表了大量关于其对医疗实践影响的文章。道德义务——尽管在这段时间里有所变化，但从医学职业诞生之初就一直在讨论。法律试图根据社会的变化以及医患关系的性质来界定这一义务。道德义务和法律义务有着内在联系，但后者肯定必须遵循前者，因为“法律与临床和研究环境中道德要求的沟通形式几乎没有关系”。随着社会标准的转变，这一过程的普通法性质导致了一条不一致且往往曲折的道路。因此，自“知情同意”这一法律原则相对较新地进入法医学词汇以来，其最终定义已经发生了变化。法律和道德上披露风险的义务的这些平行转变，给临床医生带来了一堆令人困惑的证据和建议。我们探讨“知情同意”法的发展，它是临床医生向患者披露风险的道德义务的法律反映。
