Gramer E, Leydhecker W, Krieglstein G K
Klin Monbl Augenheilkd. 1982 Jul;181(1):46-53. doi: 10.1055/s-2008-1055167.
There is some uncertainty among doctors and lawyers about the form and content of presurgical medical enlightenment of the patient. Presurgical enlightenment is of increasing significance with respect to malpractice suits. Current jurisdiction has developed principles of enlightenment that are often difficult for the doctor to handle. For routine procedures in major hospitals a standardized, pragmatically designed consent form is therefore necessary. At Würzburg University Eye Hospital the results of glaucoma and cataract surgery have been documented for years by using computer-readable forms. On the basis of these large-scale results from many thousands of procedures a written consent form was developed and tested for its suitability. Two hundred and twenty-two patients were questioned on their expectations as to proper enlightenment. The results of these broadly scattered interviews are summed up and presented. Especially with glaucoma patients, the best method of enlightenment, satisfying both medical and legal requirements, is an information booklet designed for lay people together with verbal information furnished by the doctor. Nearly all of the patients interviewed found the preoperative enlightenment complete and sufficiently clear. The majority ot them could repeat the contents of the enlightenment form four to six days after the operation. This speaks well for the adequacy of the enlightenment. As a rule, the written consent form was supplemented by verbal enlightenment from the operating physician immediately before hospitalization of the patient. A psychological investigation of preoperative anxiety with enlightened and non-enlightened patients revealed that the enlightenment form did not increase preoperative anxiety. Surgical ophthalmology lends itself to a written consent form more readily then other surgical disciplines, because diseases with poor prognoses for life are fortunately rare.
医生和律师对于患者术前医学告知的形式和内容存在一些不确定性。术前告知对于医疗事故诉讼而言愈发重要。当前的司法管辖制定了一些告知原则，而医生常常觉得难以应对。因此，对于大型医院的常规手术而言，一份标准化、设计实用的同意书是必要的。在维尔茨堡大学眼科医院，多年来一直使用计算机可读表格记录青光眼和白内障手术的结果。基于数千例手术的这些大规模结果，制定了一份书面同意书并对其适用性进行了测试。对222名患者关于他们对适当告知的期望进行了询问。总结并呈现了这些广泛分散的访谈结果。特别是对于青光眼患者，满足医学和法律要求的最佳告知方式是为外行人设计的信息手册以及医生提供的口头信息。几乎所有接受访谈的患者都认为术前告知完整且足够清晰。他们中的大多数人在术后四到六天能够复述告知表格的内容。这充分说明了告知的充分性。通常，在患者住院前，手术医生会立即进行口头告知，以补充书面同意书。一项对接受告知和未接受告知的患者术前焦虑的心理调查显示，告知表格并未增加术前焦虑。与其他外科领域相比，眼科手术更适合采用书面同意书，因为幸运的是，对生命预后不佳的疾病很少见。
