Pang M C
Department of Nursing and Health Sciences, Hong Kong Polytechnic University, Hung Hom, Kowloon, China.
Nurs Ethics. 1998 Jul;5(4):347-61. doi: 10.1177/096973309800500407.
While the movement to ensure patient's rights to information and informed consent spreads throughout the world, patient rights of this kind have yet to be introduced in mainland China. Nonetheless, China is no different from other parts of the world in that nurses are expected to shoulder the responsibility of safeguarding patients' best interests and at the same time to uphold their right to information. This paper expounds on the principle of protectiveness grounded in traditional Chinese medical ethics concerning the practice of informed consent. Nurses in China have a moral obligation to treat patients with sincerity. This notion carries a strong sense of parental protectiveness. As far as information-giving is concerned, nurses in China are ambivalent about the notion of truthfulness. The findings of an empirical study undertaken in seven Chinese cities reveal that nurses in China experience similar difficulties related to the disclosure of information as their counterparts in other parts of the world. A nurse's narrative, the Chan case, is used to illustrate the typical difficult situation that nurses in China often encounter in looking after vulnerable patients who would like to learn more about their therapeutic regimens. The moral tension embedded in nursing practice is analysed. It is found that most nurses would prefer to tell the truth to patients, but their primary ethical justification is not that of respect for patients' autonomy or safeguarding patients' right to self-determination. Rather, it is basically beneficent in nature; that is, they base their decision to reveal the truth on whether or not patients will receive more relevant treatment and better nursing care.
虽然确保患者知情权和知情同意权的运动在全球范围内广泛开展,但中国大陆尚未引入此类患者权利。尽管如此,中国与世界其他地区并无不同,护士有责任维护患者的最大利益,同时维护他们的知情权。本文阐述了中国传统医学伦理中关于知情同意实践的保护性原则。中国护士有道德义务真诚对待患者。这种观念带有强烈的家长式保护意识。就信息披露而言,中国护士对真实性的观念存在矛盾心理。在七个中国城市进行的一项实证研究结果表明,中国护士在信息披露方面遇到的困难与世界其他地区的同行类似。一个护士的叙述,即陈案,被用来例证中国护士在照顾希望更多了解其治疗方案的弱势患者时经常遇到的典型困境。分析了护理实践中蕴含的道德张力。研究发现,大多数护士更愿意向患者说实话,但他们的主要伦理依据并非尊重患者的自主权或维护患者的自决权。相反,这基本上是出于行善的目的;也就是说,他们基于患者是否会得到更合适的治疗和更好的护理来决定是否披露真相。