Tabak N
Department of Nursing, Faculty of Medicine, Tel Aviv University, Israel.
Med Law. 1996;15(1):7-16.
The author builds upon the concept of informed consent whereby the patient agrees to undergo experimental medical procedures. Ideally, the doctor will inform the patient fully on the proposed treatment so as to assure the patient's right to participate intelligently and freely in the decisions regarding his treatment. The nurse is drawn into the doctor-patient relationship in cases where the patient seeks her counsel because he feels insufficiently informed by the doctor, or because the nurse becomes aware of inadequacies in the information-giving process. She is then faced by the nurse's dilemma: a conflict between the loyalties she owes to her patient and to her physician team mate. A work sheet is presented which can help the nurse decide upon the proper course of action in solving this dilemma, guided by her personal and professional beliefs and by specific ethical concepts in the Code for Nurses. Solution of the dilemma and attainment of informed consent requires willing cooperation between doctor and nurse. Both can develop the skills for imparting information to the patient under difficult conditions and for verifying its comprehension by the patient. Both must learn to respect the patient's decision and to temper their professional skills with sensitivity, a strong moral sense and a deep respect for their fellow human beings.
作者基于知情同意的概念展开论述，即患者同意接受实验性医疗程序。理想情况下，医生会向患者充分告知拟议的治疗方案，以确保患者有权明智且自由地参与有关其治疗的决策。在患者因觉得医生提供的信息不足，或因护士意识到信息提供过程存在缺陷而向护士寻求建议的情况下，护士就被卷入了医患关系之中。此时，护士面临着两难困境：她对患者的忠诚与对医生团队伙伴的忠诚之间的冲突。文中给出了一份工作表，可帮助护士在个人和职业信念以及《护士守则》中的特定伦理概念的指导下，决定解决这一两难困境的恰当行动方案。解决这一两难困境并实现知情同意需要医生和护士的自愿合作。双方都可以培养在困难条件下向患者传递信息并核实患者是否理解的技能。双方都必须学会尊重患者的决定，并以敏感性、强烈的道德感和对他人的深深尊重来调和自己的专业技能。
