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急症医院环境中的有效同意:患者及公众的观点

Valid consent in the acute hospital setting: perspectives of patients and members of the public.

作者信息

Kovic Živa, Kobua Motheo, Fogarty Mary, Donohoe Claire L, Kelly Michael E, Fitzmaurice Gerard J, Fitzgerald Mella, Zambra Paul, Geary Una, Ward Marie E

机构信息

School of Medicine, Trinity College, The University of Dublin, Dublin 2, Ireland.

Quality and Safety Improvement Directorate, St James's Hospital, Dublin 8, Ireland.

出版信息

Ir J Med Sci. 2024 Aug;193(4):1703-1714. doi: 10.1007/s11845-024-03658-w. Epub 2024 Apr 5.

Abstract

BACKGROUND

People who interact with healthcare services have an ethical and legal right to control their own lives, to make informed decisions, and to consent to what happens to them. For consent to be considered ethically and legally valid, three key criteria must be met: consent must be given voluntarily; people must be sufficiently informed of all options; and people should have capacity to make the decision to give or withhold their consent.

AIM

This study set out to explore, through the use of surveys, the perspectives of patients and public in relation to consent.

METHOD

Surveys were developed for patients and the public and administered paper based (patients) and through social media (public).

RESULTS

One hundred and forty surveys were posted to patients, with a 38% response rate; 104 responses were received from the public. Ninety-six percent of patients were satisfied that the decision they made was informed; 100% felt they had made a voluntary decision; 98% felt the clinician seemed knowledgeable about the procedure. What matters most to the public were being informed about the risks associated with the proposed procedure and being assured that whatever choice they make they will receive the best care possible.

CONCLUSIONS

The results highlight interesting similarities and differences in relation to consent between members of the public thinking about a possible treatment, surgery, or procedure and those patients who have actually been through the process in the past 12 months. Recommendations have been developed on the basis of these findings to co-design improvements in consent practices.

摘要

背景

与医疗服务机构打交道的人在道德和法律上有权掌控自己的生活、做出明智的决定并同意对其自身所发生的事情。要使同意在道德和法律上有效,必须满足三个关键标准:同意必须是自愿给予的;人们必须充分了解所有选择;并且人们应该有能力做出给予或拒绝同意的决定。

目的

本研究旨在通过调查来探究患者和公众对于同意的看法。

方法

为患者和公众设计了调查问卷,患者采用纸质问卷形式,公众通过社交媒体进行调查。

结果

向患者发放了140份调查问卷,回复率为38%;收到公众回复104份。96%的患者对自己做出的明智决定感到满意;100%的患者觉得自己做出了自愿的决定;98%的患者认为临床医生似乎对该手术很了解。对公众来说最重要的是了解与拟议手术相关的风险,并确信无论他们做出何种选择都将得到尽可能最好的护理。

结论

结果凸显了考虑可能进行的治疗、手术或程序的公众成员与过去12个月内实际经历过该过程的患者在同意方面有趣的异同。基于这些发现提出了相关建议,以共同设计改进同意程序的方法。

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