Mazur D J
Med Decis Making. 1986 Oct-Dec;6(4):224-30. doi: 10.1177/0272989X8600600407.
Twenty-five years of appellate court decisions about informed consent in three influential states were examined to address four issues: the criteria used to define adequate informed consent; trends in court decisions; parallels between court decision making and decision analysis; the contribution of decision analytic concepts to defining "reasonable" medical informed consent. Court standards have evolved in three phases: the "medical community" standard before 1972, the "reasonable person" standard since 1972, and recent inroads toward developing an "individual preference" standard. The latter two standards form the current basis for deciding whether a patient has been adequately informed. Decision analysis offers a framework for communication about medical outcomes and probabilities, and methods for assessing preferences. Jurists and physicians should consider whether the legal system should adopt a decision analytic perspective in the doctrine of informed consent. Researchers should address issues raised by use of decision analysis for communication between the physician and the patient.
对三个具有影响力的州25年来上诉法院关于知情同意的判决进行了审查，以解决四个问题：用于界定充分知情同意的标准；法院判决的趋势；法院决策与决策分析之间的相似之处；决策分析概念对界定“合理”医疗知情同意的贡献。法院标准经历了三个阶段的演变：1972年以前的“医学界”标准，1972年以来的“理性人”标准，以及最近在制定“个人偏好”标准方面取得的进展。后两个标准构成了当前判定患者是否得到充分告知的基础。决策分析提供了一个关于医疗结果和概率的沟通框架，以及评估偏好的方法。法学家和医生应考虑法律制度在知情同意原则中是否应采用决策分析视角。研究人员应解决在医生与患者沟通中使用决策分析所引发的问题。
