患者不予签字同意的问题研究

Research patients refused to sign the consent

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。

The informed consent of the patients is the most basic rights. Informed consent generally divided into four areas： to inform, informed consent signature. Among them, the ＂signature＂ is the final act of informed con- sent. In practice signature highlights the complexity of the way to inform, the ability to understand, the state of consciousness, the legal defects of many factors. In the late 1970s, informed consent introduced in China and gradu- ally transition from moral categories to the scope of the legal norms of the physicians practicing. In the decades of the development of our country, for informed consent the most typical form is signed preoperative system. The arti- cle will focus on patients not to sign an agreement to carry out the analysis and elaboration. And the author will put forward some ideas from the general state, no clear intention of the patient or close relatives as well as the three as- pects of an emergency situation.