Brabbins C, Butler J, Bentall R
Scott Clinic, St Helens, Merseyside.
Br J Psychiatry. 1996 May;168(5):540-4. doi: 10.1192/bjp.168.5.540.
The effects of neuroleptic medication on schizophrenic patients are both positive (reduction in symptoms) and negative (adverse side-effects). Given that altered cognitive functioning may be a feature of schizophrenia, the use of neuroleptics raises important ethical and legal issues.
A selective review was carried out of papers addressing ethical arguments for and against obtaining consent from schizophrenic patients, and the ethical and legal requirements which must be met for consent to occur.
Although a balance must be met between arguments for and against obtaining consent, clinicians should seek informed consent in all but exceptional circumstances. Obtaining consent depends on the adequate presentation of information, the absence of duress and the patients' capacity to consent. Various tests of capacity to consent have been proposed.
It is proposed that clinicians employ a proforma to record attempts to obtain informed consent during routine clinical practice.
抗精神病药物对精神分裂症患者的影响既有积极的一面（症状减轻），也有消极的一面（不良副作用）。鉴于认知功能改变可能是精神分裂症的一个特征，抗精神病药物的使用引发了重要的伦理和法律问题。
对论述支持和反对从精神分裂症患者处获得同意的伦理观点以及同意发生必须满足的伦理和法律要求的论文进行了选择性综述。
尽管在支持和反对获得同意的观点之间必须取得平衡，但临床医生应在除特殊情况外的所有情况下寻求知情同意。获得同意取决于信息的充分呈现、不存在胁迫以及患者的同意能力。已经提出了各种同意能力测试方法。
建议临床医生采用一种表格形式来记录在常规临床实践中获取知情同意的尝试。
