Satohisa E
Hoyuukai Sapporo Clinic of Obstetric and Gynaecology, Sapporo, Japan.
Hokkaido Igaku Zasshi. 1998 Jan;73(1):29-33.
Obtaining informed consent perfectly is very difficult from the view of psychosomatic medicine. Medical education regarding informed consent is generally of a low level. However as it is important to defend patients' human rights, we must educate them as to the precise meaning of both "informed" and "consent". In this report I have tried to demonstrate that both the education of medical students and their social consciousness are very important. I examined students' opinions regarding the care of a sudden case of hysterectomy (Porro's emergent operation). The following students were involved: 1st year medical students (N = 73), 4th year (N = 85) and 6th year (N = 119), and 3rd year nursing students (N = 42) and midwife students (N = 27). I examined their answers by transactional analysis. The answers of the 1st year medical students reflecting the view of the child ego state were significantly greater than those of the other students (P < 0.01). But following my lecture the answers of the same 1st year students altered to reflect the view of the adult ego more (P < 0.05). We opened "the key center of psychosomatic women's health in Japan" in our clinic two years ago. Since then we have talked every month to people in general about various women's diseases, and also discussed various problems of the doctor-patient relationships during these talks. I feel that public awareness concerning informed consent has increased gradually recently in Japan.
从身心医学的角度来看，要完美地获得知情同意是非常困难的。关于知情同意的医学教育总体水平较低。然而，由于捍卫患者人权很重要，我们必须向他们传授“知情”和“同意”的确切含义。在本报告中，我试图证明医学生的教育及其社会意识都非常重要。我调查了学生们对于紧急子宫切除术（波罗氏急诊手术）护理的看法。参与调查的学生如下：一年级医学生（N = 73）、四年级（N = 85）和六年级（N = 119），以及三年级护理学生（N = 42）和助产学生（N = 27）。我通过交互分析来研究他们的答案。一年级医学生反映儿童自我状态观点的答案显著多于其他学生（P < 0.01）。但在我讲课后，同一年级学生的答案更多地转向反映成人自我的观点（P < 0.05）。两年前我们在诊所开设了“日本身心女性健康关键中心”。从那时起，我们每月都会与公众谈论各种女性疾病，并在这些谈话中讨论医患关系的各种问题。我觉得最近在日本，公众对知情同意的认识在逐渐提高。
