医院知情同意权行使主体的伦理现状调查

Ethical Investigation of the Main Body in the Implementation of Informed Consent in Hospitals

目的了解医院医务人员、患者及其家属对医院知情同意权行使主体的伦理认知现状并进行分析。方法对医生、患者、家属采用自行设计的问卷进行调查,其中对126位医生进行问卷调查方式;对150名患者、148名家属采用问卷访谈形式进行访谈。结果在法律认知上,仅56%的医务人员,20%的患者,8.8%的患者家属完全同意知情同意权行使主体是其本人;在伦理认知上,以患者本人为知情同意权的行使主体,86.5%的医务人员,54%的患者,45.3%的患者家属认为能尊重患者;55.5%的医务人员,82.7%的患者,48%的患者家属认为能对患者有利;84.9%的医务人员,34.7%的患者,14.9%的患者家属认为要贯彻患者的自主选择权。结论在中国传统文化背景下,知情同意权行使主体的法律规定与伦理认知存在巨大差异,为医院医疗纠纷留下隐患;医务人员作为知情同意的告知者,要在有关法规指导下,掌握好告知权限,以适用当前伦理认知现状。

Objective：To investigate and analyze the ethical cognitive status of the main body in the implementation of informed consent among hospital medical staff,patients and their family members.Methods：The in total 126 doctors are investigated with a self-designed questionnaire,while 150 patients and 148 family members of patients with questionnaire interviews.Results：In terms of legal cognition,only 56% of the total medical personnel investigated,20% of patients,and 8.8% of the patients＇ family members completely agree with the idea that the main body of informed consent is the patient his/herself;In terms of ethics awareness,only 86.5% of the total medical personnel investigated,54% of patients,and 45.3% of the patients＇ family members hold that the implementation of informed consent which takes the patients themselves as the main body contributes for respect for patients,while 55.5% of the medical personnel,82.7% of patients,and 48% of patients＇ family members regard the taking-patients themselves-as-main-body implementation of informed consent as beneficial for patients.84.9% of the total medical personnel investigated,34.7% of patients,and 14.9% of patients＇ family members advocate for carrying out the patient＇s independent decision making rights in implementing informed consent.Conclusion：There are huge differences in legal regulations and the public＇s ethical cognitions towards the main body of informed consent implementation under the specific context of traditional Chinese culture,which may foreshadow the medical disputes in hospitals.Medical personnel,as the informers in the implementation of informed consent,should be fully aware of the flexible range and limit of informing under the guidance of relevant regulations,in order to adapt themselves to the current situation of public＇s ethical cognition.