Zhonghua Wei Chang Wai Ke Za Zhi. 2020 Mar 25;23(3):220-224. doi: 10.3760/cma.j.cn.441530-20200224-00075.
As an emerging treatment method, watch and wait (W&W) strategy is not the standard treatment for rectal cancer patients but recommended by some guidelines. The legal risk of W&W is that once the medical behavior fails to achieve the desired effect, the patient may think that it is because of the wrong choice of treatment plan and delay of radical resection, thus causing medical dispute. As for the above legal risks, medical personnel should fulfill higher obligations when carrying out W&W strategy after neoadjuvant treatment for rectal cancer, including confirming that the treatment method has relatively reliable evidence-based medical evidence, fully implementing the information obligation and obtaining informed consent of the patient, and formulating standardized treatment procedures to ensure the standardization of medical behavior. At the same time, through patient education and communication, patients are aware of and coordinate with the efforts made by medical staff to improve patients' outcomes and quality of life, so as to understand the possible benefits and risks of this treatment strategy, as well as the efficacy and damage of complying with conventional treatment, and make final decision together with the medical staff.
作为一种新兴的治疗方法，观察等待（W&W）策略并非直肠癌患者的标准治疗方法，但得到了一些指南的推荐。观察等待的法律风险在于，一旦医疗行为未能达到预期效果，患者可能会认为这是由于治疗方案选择错误以及根治性切除延迟所致，从而引发医疗纠纷。针对上述法律风险，医务人员在对直肠癌进行新辅助治疗后实施观察等待策略时应履行更高的义务，包括确认该治疗方法有相对可靠的循证医学证据、充分履行告知义务并取得患者的知情同意，以及制定标准化的治疗程序以确保医疗行为的规范。同时，通过对患者的教育与沟通，让患者知晓并配合医务人员为改善患者预后和生活质量所做的努力，从而了解这种治疗策略可能带来的益处和风险，以及遵循传统治疗的疗效和损害，并与医务人员共同做出最终决定。
