知情不同意发生的境遇、类型与应对

Contexts, Types and Solutions of Informed Dissent

保障患者的知情同意权既是医疗行业最基本的职业要求,也是相关法律法规的要求,患者在知情后可能根据个人情况做出同意或不同意两种不同的决策,因此知情不同意也是患者知情同意权的另一种表达形式。临床中,知情不同意情况的发生往往使尊重患者自主权与有利原则不能一致,让医生陷入两难之境。知情不同意与患者个人认知、经济条件、家庭社会因素、医患沟通等多种因素相关,通过分析知情不同意发生的境遇和原因,提出应对方法,为临床工作提供参考。

Protecting the right of informed consent of patients is not only the fundamental professional requirement of the medical profession, but also the requirements of laws and regulations. After being informed, patients may either consent or dissent the clinical decisions based on their personal situations. Therefore, informed dissent is another form of the realization of right of informed consent. The occurrence of informed dissent in clinic often makes the principle of respecting patient's autonomy inconsistent with the principle of beneficence, which puts doctors in a dilemma. Informed dissent is related to patients' personal perception, financial conditions, family and social factors, doctor-patient communication and other factors. Through the analysis of the contexts and causes of informed dissent, countermeasures are put forward to provide reference for clinical practice.