Fenwick P, Beran R G
Institute of Psychiatry, London, England.
Med Law. 1997;16(2):215-23.
Informed consent requires the person to correctly understand the nature of what is offered and to be free to choose without coercion. Where there are impediments to such decision-making, then appropriate guardians or mental health laws have been provided to enhance protection. Where consent was not fully informed, an injured patient may resort to the tort of battery or negligence for remedy unless the intrusion was as a consequence of emergency treatment to an unconscious patient in the absence of next of kin. This paper reviews the UK Bolam Principle where professional standards were set by peer standards of professional conduct and the US prudent person test in which needs of a prudent patient assume priority. It concludes that there is a need to balance both the rights of patients and obligation of doctors to ensure that justice prevails. It recognises that the final standard of duty of care remains under scrutiny, and that there was a ground swell against absolute adherence to the Bolam Principle, and a need to review the circumstances of each case.
知情同意要求当事人正确理解所提供内容的性质，并能在无强制的情况下自由选择。当存在影响此类决策的障碍时，已制定了适当的监护人或精神健康法律以加强保护。如果同意并非完全知情，除非侵入行为是在没有近亲在场的情况下对昏迷患者进行紧急治疗的结果，否则受伤患者可以诉诸殴打侵权行为或过失侵权行为以寻求补救。本文回顾了英国的博勒姆原则（该原则根据同行的职业行为标准来设定专业标准）以及美国的谨慎人测试（其中谨慎患者的需求优先考虑）。文章得出结论，有必要平衡患者权利和医生义务，以确保正义得以伸张。文章认识到注意义务的最终标准仍在审查之中，而且强烈反对绝对遵守博勒姆原则，并且有必要审查每个案件的具体情况。
