Department of Law, School of Social Sciences, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
University of Leeds, Leeds, UK.
J Bioeth Inq. 2020 Dec;17(4):789-792. doi: 10.1007/s11673-020-10048-1. Epub 2020 Nov 9.
In the United Kingdom, the question of how much information is required to be given to patients about the benefits and risks of proposed treatment remains extant. Issues about whether healthcare resources can accommodate extended shared decision-making processes are yet to be resolved. COVID-19 has now stepped into this arena of uncertainty, adding more complexity. U.K. public health responses to the pandemic raise important questions about professional standards regarding how the obtaining and recording of consent might change or be maintained in such emergency conditions, particularly in settings where equipment, medicines, and appropriately trained or specialized staff are in short supply. Such conditions have important implications for the professional capacity and knowledge available to discuss the risks and benefits of and alternatives to proposed treatment with patients. The government's drive to expedite the recruitment to wards of medical students nearing the end of their studies, as well as inviting retired practitioners back into practice, raises questions about the ability of such healthcare providers to engage fully in shared decision-making.This article explores whether the legal duty on healthcare practitioners to disclose the material risks of a proposed medical treatment to a patient should be upheld during pandemic conditions or whether the pre-eminence of patient autonomy should be partly sacrificed in such exceptional circumstances. We argue that measures to protect public health and to respect autonomous decision-making are not mutually exclusive and that there are good reasons to maintain professional standards in obtaining consent to treatment even during acute pressures on public health systems.
在英国,关于需要向患者提供多少关于拟议治疗的益处和风险的信息的问题仍然存在。关于医疗保健资源是否能够容纳扩展的共同决策过程的问题尚未得到解决。COVID-19 现已进入这一不确定领域,增加了更多的复杂性。英国对大流行的公共卫生应对措施提出了关于专业标准的重要问题,即在这种紧急情况下,同意的获取和记录可能会发生怎样的变化或如何保持不变,特别是在设备、药品和适当训练有素或专业人员短缺的情况下。这种情况对与患者讨论拟议治疗的风险和益处以及替代方案的专业能力和知识有重要影响。政府急于招募即将完成学业的医学生到病房,以及邀请退休医生重新执业,这引发了人们对这些医疗保健提供者是否能够充分参与共同决策的质疑。本文探讨了在大流行期间,医疗保健从业者向患者披露拟议医疗的重大风险的法律义务是否应得到维持,或者在这种特殊情况下,患者自主权的至上地位是否应部分牺牲。我们认为,保护公共健康和尊重自主决策的措施并非相互排斥,即使在公共卫生系统面临巨大压力的情况下,也有充分的理由在获得治疗同意方面维持专业标准。