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美国医疗服务中的生物伦理学与知情同意

Bioethics and informed consent in American health care delivery.

作者信息

Barkes P

出版信息

J Adv Nurs. 1979 Jan;4(1):23-38. doi: 10.1111/j.1365-2648.1979.tb02985.x.

Abstract

Bioethics is a multi-dimensional discipline. The traditional aspect being medical ethics, a branch of Western philosophy which, since the time of Hippocrates, has sought to formulate rules of proper conduct for physicians. Ethics and informed consent are interrelated issues. Consent is the central issue on which hangs most of the ethical problems in human experimentation. The informed consent of the human patient is the ultimate protection from the hazards of research and therapy in medicine, the basic premise of this being that every human being has the right to determine what shall be done to his own body. The patient must have full prognosis, complications, sequelae, discomforts, costs, inconveniences, risks and expectations. Medically and ethically what should the patient be told? There appears to be no obvious format, but the patient should be told enough to allow him to make a rational decision. This paper contains an analysis of the reactions of just a few American nurses to this dilemma. The nurse who attempts to use only her scientific training to determine ethical conduct is in a quandary because seldon is there empirical evidence available to support her decision, no matter what it is.

摘要

生物伦理学是一门多维度的学科。传统层面是医学伦理学,它是西方哲学的一个分支,自希波克拉底时代以来,一直致力于为医生制定恰当行为的规则。伦理学和知情同意是相互关联的问题。同意是人类实验中大多数伦理问题所围绕的核心问题。人类患者的知情同意是防范医学研究和治疗风险的最终保障,其基本前提是每个人都有权决定对自己身体做什么。患者必须充分了解预后、并发症、后遗症、不适、费用、不便、风险和期望。从医学和伦理角度来看,应该告知患者什么呢?似乎没有明显的固定形式,但应该告知患者足够的信息,以便他能够做出理性的决定。本文仅对几位美国护士对这一困境的反应进行了分析。试图仅依靠其科学训练来确定道德行为的护士会陷入困境,因为无论她做出何种决定,几乎都没有实证证据来支持。

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