蒙哥马利诉布勒姆案：为白内障手术签署知情同意书时，实习外科医生是否是“实质性风险”？
Montgomery in, Bolam out: are trainee surgeons 'material risks' when taking consent for cataract surgery?
机构信息
Victoria Eye Unit, Hereford County Hospital, Union Walk, Hereford, HR1 2ER, UK.
King's Chambers, 36 Young Street, Manchester, M3 3FT, UK.
出版信息
Eye (Lond). 2020 Aug;34(8):1334-1340. doi: 10.1038/s41433-020-0785-4. Epub 2020 Feb 4.
Abstract
Trainee involvement in cataract surgery is vital to allow proper training of the next generation of ophthalmic surgeons. However, recent changes in the UK Law, coupled with open publication of National Cataract Dataset results, lead us to conclude that the status of being a trainee is itself a material risk that now needs to be divulged to patients during the consent process. The opinions of current trainee surgeons in the UK were sampled via questionnaire and clinical negligence counsel was involved in the authorship of the paper in order to analyse the legal issues at stake. Attitudes towards consent regarding trainee involvement in UK cataract surgery need to change.
摘要
实习生参与白内障手术对于培养下一代眼科医生至关重要。然而，英国法律的最新变化，加上全国白内障数据集结果的公开出版，使我们得出结论，实习生的身份本身就是一个重大风险，现在需要在知情同意过程中向患者披露。通过问卷调查对英国现任实习外科医生的意见进行了抽样调查，并邀请了临床过失律师参与论文的撰写，以分析所涉法律问题。英国白内障手术中实习生参与问题的同意态度需要改变。
相似文献
1
Montgomery in, Bolam out: are trainee surgeons 'material risks' when taking consent for cataract surgery?蒙哥马利诉布勒姆案：为白内障手术签署知情同意书时，实习外科医生是否是“实质性风险”？
Eye (Lond). 2020 Aug;34(8):1334-1340. doi: 10.1038/s41433-020-0785-4. Epub 2020 Feb 4.
2
Comment on: Montgomery in, Bolam out: are trainee surgeons 'material risks' when taking consent for cataract surgery?评论：蒙哥马利原则适用，博勒姆原则不再适用：白内障手术获得知情同意时实习外科医生是否构成“实质风险”？
Eye (Lond). 2022 Feb;36(2):470. doi: 10.1038/s41433-020-01387-9. Epub 2021 Jan 21.
3
Response to: 'Montgomery in, Bolam out: are trainee surgeons "material risks" when taking consent for cataract surgery?'.回应：“蒙哥马利原则适用，博勒姆原则摒弃：白内障手术取得患者同意时实习外科医生是否构成‘实质风险’？”
Eye (Lond). 2021 Sep;35(9):2640-2641. doi: 10.1038/s41433-020-01168-4. Epub 2020 Sep 2.
4
Cataract surgery and consent; recall, anxiety, and attitude toward trainee surgeons preoperatively and postoperatively.白内障手术与知情同意；术前及术后对实习外科医生的召回、焦虑及态度
J Cataract Refract Surg. 2004 Jul;30(7):1479-85. doi: 10.1016/j.jcrs.2003.11.050.
5
Consent for cataract surgery training: a national trainers' survey.白内障手术培训同意书：全国培训师调查。
Eye (Lond). 2012 May;26(5):666-70. doi: 10.1038/eye.2012.2. Epub 2012 Feb 3.
6
Patients' attitudes towards trainee surgeons performing cataract surgery at a teaching hospital.患者对教学医院实习外科医生进行白内障手术的态度。
Eye (Lond). 2008 Sep;22(9):1183-6. doi: 10.1038/sj.eye.6702872. Epub 2007 May 25.
7
Patient perspective on the participation of ophthalmology residents in their cataract surgery.患者对眼科住院医师参与其白内障手术的看法。
Can J Ophthalmol. 2023 Oct;58(5):443-448. doi: 10.1016/j.jcjo.2022.05.002. Epub 2022 May 24.
8
Royal College of Ophthalmologists' National Ophthalmology Database study of cataract surgery: report 6. The impact of EyeSi virtual reality training on complications rates of cataract surgery performed by first and second year trainees.皇家眼科医师学院国家眼科数据库白内障手术研究：报告 6. EyeSi 虚拟现实培训对第一和第二年受训者进行白内障手术并发症发生率的影响。
Br J Ophthalmol. 2020 Mar;104(3):324-329. doi: 10.1136/bjophthalmol-2018-313817. Epub 2019 May 29.
9
Informed consent in cataract surgery.白内障手术中的知情同意
Curr Opin Ophthalmol. 2009 Jan;20(1):52-5. doi: 10.1097/ICU.0b013e32831b6dcf.
10
A comparison of techniques: informed consent for resident involvement in cataract surgery.技术比较：白内障手术中患者知情同意书的制定。
Can J Ophthalmol. 2012 Apr;47(2):113-7. doi: 10.1016/j.jcjo.2012.01.017.
引用本文的文献
1
Correspondence on: a model for anterior vitrectomy in real patients: simulation for practical training.通信主题：真实患者眼前段玻璃体切除术模型：用于实践培训的模拟
Eye (Lond). 2024 Dec;38(17):3399. doi: 10.1038/s41433-024-03296-7. Epub 2024 Aug 26.
2
Challenge of achieving truly individualised informed consent in therapeutic endoscopy.治疗性内镜检查中实现真正个性化知情同意的挑战。
Frontline Gastroenterol. 2023 Nov 8;15(3):183-189. doi: 10.1136/flgastro-2023-102545. eCollection 2024 May.
3
Material risk: vitreoretinal surgery, evisceration, enucleation and sympathetic ophthalmia-where are we currently?材料风险：玻璃体视网膜手术、眼内容剜除术、眼球摘除术和交感性眼炎——我们目前处于什么位置？
Eye (Lond). 2023 Dec;37(17):3542-3550. doi: 10.1038/s41433-023-02562-4. Epub 2023 May 17.
4
Only eye study 3 (OnES 3): a qualitative study into how surgeons approach surgery in patients with only one seeing eye.仅一眼研究 3（OnES 3）：一项定性研究，探讨了仅一眼可见的患者接受手术时，外科医生的手术方法。
BMJ Open. 2022 Dec 13;12(12):e064597. doi: 10.1136/bmjopen-2022-064597.
5
Real-time artificial intelligence evaluation of cataract surgery: A preliminary study on demonstration experiment.白内障手术的实时人工智能评估：示范实验的初步研究。
Taiwan J Ophthalmol. 2022 Apr 13;12(2):147-154. doi: 10.4103/tjo.tjo_5_22. eCollection 2022 Apr-Jun.
6
Comment on: Montgomery in, Bolam out: are trainee surgeons 'material risks' when taking consent for cataract surgery?评论：蒙哥马利原则适用，博勒姆原则不再适用：白内障手术获得知情同意时实习外科医生是否构成“实质风险”？
Eye (Lond). 2022 Feb;36(2):470. doi: 10.1038/s41433-020-01387-9. Epub 2021 Jan 21.
本文引用的文献
1
Does Orthopaedic Training Compromise the Outcome in Knee Joint Arthroplasty?骨科培训是否会影响膝关节置换手术的结果？
J Surg Educ. 2018 Sep-Oct;75(5):1292-1298. doi: 10.1016/j.jsurg.2018.02.011. Epub 2018 Mar 21.
2
Post-operative Complications Following Emergency Operations Performed by Trainee Surgeons: A Retrospective Analysis of Surgical Deaths.实习外科医生进行急诊手术后的术后并发症：手术死亡的回顾性分析
World J Surg. 2018 Aug;42(8):2329-2338. doi: 10.1007/s00268-018-4465-5.
3
Heart Valve Surgery Performed by Trainee Surgeons: Meta-Analysis of Clinical Outcomes.实习外科医生实施的心脏瓣膜手术：临床结果的荟萃分析
Heart Lung Circ. 2018 Apr;27(4):420-426. doi: 10.1016/j.hlc.2017.10.009. Epub 2017 Oct 27.
4
It All Depends on Who Does What: A Survey of Patient and Family Member Comfort With Surgical Trainees Operating.这取决于谁做什么：一项关于患者和家属对手术实习生操作舒适度的调查。
J Surg Educ. 2017 Nov-Dec;74(6):1001-1006. doi: 10.1016/j.jsurg.2017.05.014. Epub 2017 Jun 12.
5
A systematic review of the effects of residency training on patient outcomes.一项关于住院医师培训对患者结局影响的系统评价。
BMC Med. 2012 Jun 28;10:65. doi: 10.1186/1741-7015-10-65.
6
Consent for cataract surgery training: a national trainers' survey.白内障手术培训同意书：全国培训师调查。
Eye (Lond). 2012 May;26(5):666-70. doi: 10.1038/eye.2012.2. Epub 2012 Feb 3.
7
The Cataract National Dataset electronic multicentre audit of 55,567 operations: risk stratification for posterior capsule rupture and vitreous loss.白内障国家数据集对55567例手术的电子多中心审计：后囊破裂和玻璃体丢失的风险分层
Eye (Lond). 2009 Jan;23(1):31-7. doi: 10.1038/sj.eye.6703049. Epub 2008 Mar 7.
Zotero 插件