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Abstract 摘要

An informed consent document is vital for all surgical procedures and medical treatments. Proper documentation and counseling of patients is important for informed consent. Opinion polls conducted in this essay show that the majority of people in China today have accepted informed consent as a legally binding medical policy, yet they do not fully understand the ethical and legal connotations involved, particularly the idea of the patient’s autonomy. As a result, the patient’s own experience as a first-person narrative is often ignored and his/her subjectivity is blurred when his/her family’s subjectivity intervenes. According to the essay, the problem appears when liberalism—which emphasizes individual autonomy and rights—does not square with the Confucian tradition that emphasizes family as a coherent unit. The essay also points out that there is a huge difference in patients’ perceptions of “individual rights,” due to their different levels of education. The author argues that informed consent could be better practiced if both doctors and patients were “well informed” and understood the moral and legal implications of informed consent.

知情同意作為一項權利,患者成為闡述其體驗的首要主體。實證調查表明,患者對於其權利認知還存在不足,多數偏好於患者與家庭共用模式;在實踐中,知情與同意在主體層面存在分離現象。對於病情的告知傾向於任選模式,但家庭是不可或缺的告知物件,對於診療、護理等相關資訊,傾向於患者模式;在同意方面,家屬成為獲取同意的主體。經濟因素成為患方“不同意”的首要原因。對於不同維度的調查表明,基於女性相對脆弱性特點,他們對於家庭的依賴性更強,其維權意識更強;在年齡層面,青少年對於權利的認知更理性,具有現代契約精神。在地域層面,縣級以上城市居民對於權利認知度更高;職業往往與教育程度相關,表明農民的個體依賴性更強;政府機關以及事業單位人員個體主體性更強。為此,需要加強患者權利教育,提升主體意識;對醫務人員加強職業道德教育,履行告知義務,強化醫患信任;深化醫療衛生體制改革,為知情同意的踐行提供空間與時間。

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