Spring D B, Akin J R, Margulis A R
Radiology. 1984 Sep;152(3):609-13. doi: 10.1148/radiology.152.3.6463241.
A detailed questionnaire regarding the obtaining of patient consent for the administration of intravenous contrast agents was sent to 3845 radiologists in those hospitals across the United States having more than 100 beds. The results represent the current community practice and opinion of the 1547 radiologists (40%) who answered. They showed that 66% of respondents obtained no type of informed consent before injecting intravenous contrast agents. Half of those who did obtain consent did not inform their patients of possible specific major adverse reactions. Half of those who did not obtain consent believed the risk of adverse reaction was remote. Another 40% believed the consent procedure might heighten anxiety and, therefore, increase the risk of reaction. Obtaining informed consent, however, was not significantly associated with an increased incidence of major reactions. Since 8% of the respondents indicated some involvement in malpractice lawsuits regarding the question of informed consent for various procedures, the obtaining of informed consent might lessen the risk of exposure to malpractice litigation. Additional results showed that written consent did not appear to lessen the number of studies performed and that it offered more specific information to the patient regarding complications. Finally, most radiologists (80%) requested a specific policy regarding informed consent from at least one of the following organizations: the American College of Radiology (ACR) (96%), the Radiological Society of North America (RSNA) (26%), state chapters of the ACR (15%).
一份关于获取患者静脉注射造影剂同意书的详细调查问卷被发送给了美国所有拥有100张以上床位医院的3845名放射科医生。结果代表了1547名回复的放射科医生(占40%)当前的行业实践和观点。结果显示,66%的受访者在注射静脉造影剂之前未获取任何形式的知情同意。在那些确实获取了同意的人中,有一半没有告知患者可能出现的特定严重不良反应。在那些未获取同意的人中,有一半认为不良反应的风险很小。另外40%的人认为同意程序可能会加剧患者焦虑,从而增加反应风险。然而,获取知情同意与严重反应发生率的增加并无显著关联。由于8%的受访者表示曾参与过因各种程序的知情同意问题引发的医疗事故诉讼,获取知情同意可能会降低面临医疗事故诉讼的风险。其他结果显示,书面同意似乎并未减少所进行检查的数量,但它能为患者提供更多关于并发症的具体信息。最后,大多数放射科医生(80%)要求至少从以下组织之一制定关于知情同意的具体政策:美国放射学会(ACR)(96%)、北美放射学会(RSNA)(26%)、ACR的州分会(15%)。