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知情同意是患者最基本的权利。知情同意一般分为四个环节:告知、知情、同意、签字。其中,“签字”是知情同意的最终行为方式。由于其在具体实践中常受到告知方式、理解能力、意识状态、法理缺陷等诸多因素的影响而突显出它的复杂性。我国于20世纪70年代后期开始将知情同意引入,并逐渐由医师执业道德范畴过渡到了法律规范的范畴。知情同意在我国发展的几十年中,最为典型的形式就是术前签字制度。文章将集中对患者不予签字同意进行分析和阐述,并从一般状态、患者或近亲属无明确意思表示以及紧急情况三个方面提出笔者的几点设想。
Informed consent is the most basic right of the patient. Informed consent is generally divided into four areas: inform, know, agree, sign. Among them, “sign ” is the final form of informed consent. Its complexity is highlighted by the fact that it is often influenced by many factors such as the way of informing, understanding ability, state of consciousness, legal deficiency and so on. In the late 1970s, China began to introduce informed consent, and gradually moved from the scope of physician practice ethics to the scope of legal norms. In the decades of development of informed consent in our country, the most typical form is the preoperative signature system. The article will focus on patients without the consent of the signature analysis and elaboration, and from the general state, the patient or close relatives have no clear meaning and emergency situations put forward several ideas of the author.