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激素避孕与知情同意

Hormonal Contraception and the Informed Consent.

作者信息

Hilger David J, Raviele Kathleen M, Hilgers Teresa A

机构信息

Omaha Guild of the CMA, Omaha, NE, USA.

Dekalb Medical, Decatur, GA, USA.

出版信息

Linacre Q. 2018 Nov;85(4):375-384. doi: 10.1177/0024363918813579. Epub 2018 Dec 4.

Abstract

UNLABELLED

Since the 1960s, hormonal contraceptives have become the most commonly used method of pregnancy prevention in the United States and the world. Oral contraceptives are used by a large percentage of women, including Christian women. There are known health risks to women demonstrated in research published since Pope Paul VI's prophetic encyclical in 1968. These risks include venous thrombosis, cardiovascular risks, and an increased risk of cancer. These risks are medically recognized with continued scientific debate on the degree. The risks are significantly increased with preexisting conditions and in certain demographic groups. Discussing known and potential treatment risks is a standard that is both accepted by the medical community and is increasingly expected by patients. This discussion can be accomplished by the mechanism and principle of informed consent. Depending on the circumstances, abstinence or fertility awareness-based methods (FABMs) should be presented to patients. FABMs are licit, safe, and effective methods of pregnancy prevention. Informed consent is the most effective means of providing patients with pertinent information on the significant risks of contraception.

SUMMARY

This article discusses the use of the informed consent to provide patients with information on the medical and ethical risks of oral contraceptives. FABMs and abstinence are presented as effective, safe, and licit preferences to oral contraceptives. Discussing known and potential treatment risks is accepted by the medical community and expected by patients (shared decision making). The authors discuss the historical context of Pope Paul VI's encyclical in relationship to the development and rapid adoption of oral contraceptives.

摘要

未标注

自20世纪60年代以来,激素避孕法已成为美国乃至全球最常用的避孕方法。包括基督教女性在内的很大一部分女性都在使用口服避孕药。自教皇保罗六世1968年发布具有预言性的通谕以来,已有研究表明口服避孕药对女性存在已知的健康风险。这些风险包括静脉血栓形成、心血管风险以及患癌风险增加。这些风险在医学上已得到认可,只是在风险程度上仍存在持续的科学争论。在已有疾病和某些特定人群中,这些风险会显著增加。讨论已知和潜在的治疗风险是医学界认可且患者日益期待的标准做法。这种讨论可通过知情同意机制和原则来实现。根据具体情况,应向患者介绍禁欲或基于生育意识的方法(FABMs)。FABMs是合法、安全且有效的避孕方法。知情同意是向患者提供有关避孕重大风险相关信息的最有效方式。

总结

本文讨论了通过知情同意向患者提供口服避孕药医学和伦理风险信息的情况。FABMs和禁欲被视为比口服避孕药更有效、安全且合法的选择。讨论已知和潜在的治疗风险为医学界所接受且患者有所期待(共同决策)。作者探讨了教皇保罗六世通谕的历史背景与口服避孕药的发展及迅速普及之间的关系。

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本文引用的文献

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Contemporary Hormonal Contraception and the Risk of Breast Cancer.当代激素避孕与乳腺癌风险。
N Engl J Med. 2017 Dec 7;377(23):2228-2239. doi: 10.1056/NEJMoa1700732.
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Combined oral contraceptives: venous thrombosis.复方口服避孕药:静脉血栓形成
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