Ward Joel, Kalsi Dilraj, Chandrashekar Anirudh, Fulford Bill, Lee Regent, Herring Jonathan, Handa Ashok
Nuffield Department of Surgical Sciences, Oxford University, Oxford OX3 9DU United Kingdom.
Nuffield Department of Surgical Sciences, Oxford University, Oxford OX3 9DU United Kingdom.
Patient Educ Couns. 2020 May 15. doi: 10.1016/j.pec.2020.05.017.
The UK Supreme Court Montgomery judgement marks a decisive shift in the legal test of duty of care in the context of consent to treatment from the perspective of the clinician (as represented by Bolam rules) to that of the patient. This has important implications in the surgical field worldwide, where informed consent is critical. This paper aims to explain the ruling and how it impacts the consent process. The case and ruling are outlined and summarised as pertaining to consent and requirements for validity; a shift from the clinician's interpretation about what would be best for patients to the values of the particular patient concerned in the decision in question. A sample of recent commentaries is reviewed. Four examples illustrate some of the practical applications of the Montgomery ruling on consent and how the ruling can empower doctors and patients to make mutually beneficial shared decisions. Future consent should be obtained using a Montgomery compliant strategy in accordance with the principles of shared decision making.
英国最高法院的蒙哥马利判决标志着在治疗同意方面，注意义务的法律测试发生了决定性转变，即从临床医生的角度（以博勒姆规则为代表）转向患者的角度。这在全球外科领域具有重要意义，因为知情同意至关重要。本文旨在解释该裁决及其对同意过程的影响。将概述并总结该案例及裁决，涉及同意及有效性要求；从临床医生对何为最有利于患者的解读转向特定患者在相关决策中的价值观。还将回顾近期一些评论。四个例子说明了蒙哥马利裁决在同意方面的一些实际应用，以及该裁决如何使医生和患者能够做出互利的共同决策。未来应根据共同决策原则，采用符合蒙哥马利要求的策略来获取同意。
