Center for Bioethics, Ohio State University, Columbus, OH, USA.
HEC Forum. 2020 Sep;32(3):239-251. doi: 10.1007/s10730-020-09404-w.
Informed consent is normally understood as something that a patient gives prior to a medical intervention that can render it morally permissible. Whether or not it must be given prior to the intervention is debated. Some have argued that subsequent consent-that is, consent given after a medical intervention-can also render an otherwise impermissible act permissible. If so, then a patient may give her consent to an intervention that has already been performed and thereby justify a physician's (paternalistic) act retroactively. The purpose of this paper is to argue that even if subsequent consent can render an otherwise impermissible act permissible, doctors are still blameworthy if they rely on it when prior consent could be given, because they would be banking on the justification of their interventions. Since doctors can only guess if patients will consent after the fact, they would be placing their patients at unreasonable risk of being disrespected as persons.
知情同意通常被理解为患者在可以使其在道德上允许的医疗干预之前给予的同意。是否必须在干预之前给予知情同意存在争议。一些人认为，随后的同意——即在医疗干预之后给予的同意——也可以使原本不允许的行为变得允许。如果是这样，那么患者可以同意已经进行的干预，从而使医生的（家长式作风的）行为具有追溯效力。本文的目的是论证，即使随后的同意可以使原本不允许的行为变得允许，医生如果在可以给予事先同意的情况下依赖于它，仍然是有责任的，因为他们将依靠对干预的正当化。由于医生只能猜测事后患者是否会同意，他们将使患者面临被不尊重为个人的不合理风险。
