Faculty of Medicine and Health, Sydney School of Public Health, Sydney Health Ethics, The University of Sydney, Sydney, Australia.
Department of Philosophy, Macquarie University, Macquarie Park, Australia.
Med Law Rev. 2024 Aug 1;32(3):356-372. doi: 10.1093/medlaw/fwae015.
In recent years, concerns about the financial burdens of health care and growing recognition of the relevance of cost to decision making and patient experience have increasingly focused attention on financial 'transparency' and disclosure of costs to patients. In some jurisdictions, there have been calls not only for timely disclosure of costs information, but also for 'informed financial consent'. However, simply putting the 'financial' into 'informed consent' and invoking an informed consent standard for cost information encounters several ethical, legal, and practical difficulties. This article will examine the viability and desirability of 'informed financial consent', and whether it is possible to derive ideas from traditional informed consent that may improve decision making and the patient experience. We argue that, while there are important legal, ethical, and practical challenges to consider, some of the principles of informed consent to treatment can usefully guide financial communication. We also argue that, while medical practitioners (and their delegates) have an important role to play in bridging the gap between disclosure and enabling informed (financial) decision making, this must be part of a multi-faceted approach to financial communication that acknowledges the influence of non-clinical providers and other structural forces on discharging such obligations.
近年来，人们越来越关注医疗保健的财务负担，并且越来越认识到成本与决策和患者体验的相关性，这使得人们越来越关注财务“透明度”和向患者披露成本。在一些司法管辖区，不仅呼吁及时披露成本信息，还呼吁“知情财务同意”。然而，仅仅将“财务”纳入“知情同意”并援引成本信息的知情同意标准，就会遇到一些伦理、法律和实际困难。本文将探讨“知情财务同意”的可行性和可取性，以及是否可以从传统的知情同意中汲取一些可能改善决策和患者体验的想法。我们认为，尽管需要考虑重要的法律、伦理和实际挑战，但治疗知情同意的一些原则可以为财务沟通提供有用的指导。我们还认为，虽然医疗从业者（及其代表）在缩小披露和实现知情（财务）决策之间的差距方面发挥着重要作用，但这必须是财务沟通多方面方法的一部分，该方法承认非临床提供者和其他结构力量对履行此类义务的影响。
