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Abstract 摘要

The doctors' obligation to inform means that the doctor shall inform the patient of related information on diagnosis and treatment. Specifically, it includes the following three aspects: 1) Explanation of diagnosis, that is, the explanation made by the doctor about the health condition of the patient according to medical diagnosis; 2) Ex-planation of measures used in invasive diagnosis-both preliminary and final-and treatment plan according to the diagnosis; 3) Explanation of neither diagnosis nor treatment, that is, explanation on why no diagnosis and treatment are available due to the insufficient professional skills of the doctor or lack of medical equipments.

In the doctor-patient relationship, the doctor's obligation to inform reflects the feature of independence, subjectivity, rights, self- determination, and autonomy of the patient. The aim of medical treatment is to cure illness and save the life of the patient so that medical activities should be patient-centered, and respect the patient. To treat patient as equal is the prime ethical requirement for a doctor. Legally, the doctor's obligation to inform reflects the common rule of the doctor's good conducts. It is an important component in diagnosing and treating. In addition, it plays an important part in fulfilling the responsibility of the doctor. Whether the doctor has performed obligation to inform should be taken as important evidence in judging whether a medical error has occurred. If harms to the patient or delay of treatment happen due to the doctor's insufficient or inappropriate explanations about the risks of invasive diagnosis measures and treatment schedule, the doctor should take the responsibility of tort or harm compensation for his or her failure in informing. Reflecting the change of modern medicine from a bio-medical model to a bio-psycho- socio model, to inform the patient fully will help the patient gain an all-around and correct knowledge about his or her illness and take an active role in treating the disease. The process of informing is also a process of medical and health care education. To inform the patient fully will help to establish and maintain a good, reasonable and harmonious doctor-patient relationship.

What should be noted is we should give close attention to the conflicts of various values in informed consent, including social and individual interests and duties to inform the patient and to protect the others. Acknowledging and ranking these conflicting values is thus important. Generally speaking, when patient's autonomy conflicts with public interests, the patient's autonomy should be limited by public interests. When the patient's autonomy endangers his own health and life, the protection of the patient's health and life will be the prime value. Protective treatment is an important rule of medical ethics and legal obligation. But the practice of protective treatment will deprive the patient's autonomy and individuality as it relieves the patient's suffering. Nevertheless, protective treatment is a reality and the solution to the problem will only depend on the careful discretion of the doctor.

醫生的告知義務,是指在醫療工作中,醫方應當就患者的診療資訊向患者做出適當的說明和解釋。醫生告知義務突顯了患者的人格獨立,在法律上體現為醫生的普遍行為準則,並具有對醫療行為的歸責意義。適當的履行告知義務有利於增強和提高治療效果,有利於建立良好的醫患關係,從而促進醫療事業的發展。應當注意的是,在利益主多元化的社會中,患者的知情同意與社會利益及生命價值的衝突,告知義務與保護性醫療的衝突必須予以關注,明確衝突中的價值排序。

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