生命伦理学中的自主与信任

Independent and Trust in Bioethics

针对当前医患信任危机的一种典型的解决方案来自于生命伦理学中所提出的尊重自主原则,知情同意是其在制度上的表现。但在医疗实践中,制度化知情同意的实施本身就面临着理论和实践上的困难,在利益冲突的情况下,这些困难都可能转变为医患信任的破坏力量,因此,我们必须在更加积极的意义上理解病人的自主,把它看作伦理规范,而不仅仅是法律条文,只有这样才能增进医患信任。

In bioethics, the principle of respect for autonomy is taken as a typical solution for current crisis of doctor-patient trust; informed consent is its institutional representation. In medial practice, the implementation of informed consent will face difficulties not only in theory but also in practice. In the case of conflict of interest, these difficulties are likely to turn into a destructive force of doctor-patient trust. So, we must understand patient autonomy in a more positive sense and regard it as ethical norms rather than the law. Only in this way can the doctor-patient trust be enhanced.