Newton J, Hawes R, Jamidar P, Harig J, Lehman G
Indiana University Medical Center, Indianapolis 46202.
Dig Dis Sci. 1994 Aug;39(8):1714-8. doi: 10.1007/BF02087782.
Prior to performance of gastrointestinal endoscopic procedures, physicians are generally required to appraise patients of potential risks, benefits, and alternatives. Components of the informed consent process require that: (1) consent be voluntary; (2) the patient be sufficiently mentally capable to engage in rational decision-making; and (3) "adequate information" be conveyed. Controversies reflected in both medical and legal literature concern the definition of "adequate information." To sample current opinion regarding consent for both diagnostic and therapeutic ERCP, members of the Indiana Gut Club and Midwest Gut Club were polled. From this group of academic and private practice physicians, 81 completed evaluations were compiled. Greater than 90% of physicians believed that pancreatitis and pancreatitis/bleeding/perforation must be mentioned for diagnostic and therapeutic ERCP, respectively. There was variation of opinion as to whether patients must be informed of potential need for surgery, prolonged hospital stay, or death. The performing physician was felt to be ultimately responsible for obtaining consent, although other health-care team members, excluding a secretary, could participate.
在进行胃肠内镜检查之前，医生通常需要向患者告知潜在的风险、益处和替代方案。知情同意过程的组成部分要求：（1）同意是自愿的；（2）患者在精神上有足够的能力进行理性决策；（3）传达“充分的信息”。医学和法律文献中反映的争议涉及“充分的信息”的定义。为了了解当前对于诊断性和治疗性内镜逆行胰胆管造影（ERCP）同意书的看法，对印第安纳肠道俱乐部和中西部肠道俱乐部的成员进行了调查。从这群学术和私人执业医生中，收集了81份完整的评估。超过90%的医生认为，对于诊断性ERCP必须提及胰腺炎，对于治疗性ERCP必须提及胰腺炎/出血/穿孔。对于是否必须告知患者潜在的手术需求、延长住院时间或死亡风险，存在意见分歧。尽管除秘书外的其他医疗团队成员可以参与，但实施手术的医生被认为最终负责获得同意。
