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危机与知情同意:法律与医学失调分析

Crisis and informed consent: analysis of a law-medicine malocclusion.

作者信息

Carnerie F

出版信息

Am J Law Med. 1987;12(1):55-97.

PMID:3661577
Abstract

Many individuals develop a temporary state of cognitive and emotional impairment after being diagnosed with catastrophic illness. Thus, when crucial decisions about medical treatment are required, they are unable to assimilate information; or worse, the legal need to be informed can rival a psychological desire to not be informed. The Canadian informed consent doctrine is unresponsive to crisis and clinically impracticable, and so paradoxically compromises the integrity and autonomy it was designed to protect. Many aspects of the physician-patient relationship and clinical setting also undermine the philosophical values enshrined in this doctrine. This further jeopardizes the individual's integrity. The Article explores proposals for change such as delaying the informing and consenting, improving the concept of consent, and improving the role of the physician.

摘要

许多人在被诊断患有重大疾病后会出现认知和情绪受损的暂时状态。因此,当需要做出关于医疗治疗的关键决策时,他们无法吸收信息;或者更糟的是,法律上被告知的要求可能与不想被告知的心理愿望相冲突。加拿大的知情同意原则对危机反应迟钝且在临床上不切实际,因此自相矛盾地损害了其旨在保护的完整性和自主性。医患关系和临床环境的许多方面也破坏了这一原则所体现的哲学价值观。这进一步危及个人的完整性。本文探讨了一些变革建议,如推迟告知和同意、改进同意的概念以及改善医生的角色。

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