Academic literature on the topic '知情同意權 (醫療法)'

LANGUAGE NOTE | Document text in Chinese知情同意是現代生命倫理學最重要的概念之一，也是現代生命倫理學所以充滿活力和備受世人囑目的重要原因。知情同意這一概念雖然已經歷100 多年的歷史，但在《紐倫堡法典》誕生以前，知情同意往往只是作為醫生爭取病人的配合和支持，以提高治療效果，或者為防範醫療糾紛而採取的一種手段。只是在《紐倫堡法典》問世後，特別是伴隨著聯合國的《世界人權宣言》發表後50 多年的人權運動蓬勃發展，知情同意獲得了新的意義，它首先被理解為對人的生命權和健康權的尊重，對人的權利的尊重。的確，人的生命和健康首先是屬於自己的，因而對生命和健康的任何干預，當然理應得到本人的同意，儘管這種干預有益於生命和健康的維護。特別是在當代醫學對人體生命和健康干預的力度越來越大，後果越來越嚴重，影響越來越深遠的情況下，人們怎能不關心醫學可以給本人帶來的後果呢？怎能不把對本人生命和健康的處置權利掌握在自己的手中呢？正因為如此，知情同意在全世界不同地域、不間民族和不同文化背景的國家，都得到了廣泛的認同，並體現在許多國家醫事和科學研究的法律檔中，體現在廣大醫務人員的行動中。但是，人們對知情同意的理解和認識，由於各自的文化背景和國家體制的差異，卻存在眾多的不同；同時，由於各自國家的醫療習慣和傳統的不同，在實踐知情同意原則時也遇到了各種各樣的問題。為了推動對這一問題的研究，本刊這一期就此發表了一組文章，從不同角度就知情同意原則做了分析，我們希望引起對知情同意的進一步討論和研究。DOWNLOAD HISTORY | This article has been downloaded 11 times in Digital Commons before migrating into this platform.

LANGUAGE NOTE | Document text in Chinese在臨牀實踐中所說的病人自主是指病人有知情同意的權利。由於醫療本身存在風險、患者的權利意識日益增強、醫生的職務行為有時會威脅到其自身利益，使得患者的決定和醫生的決定時有不一致的情況發生。雖然醫療上的善就是為了患者的利益，但它的實現需要醫生的努力、患者的知情同意等中介條件，於是在臨牀上會出現矛盾。其根本原因應在於知情同意和醫療行善的主體的不一致， 前者是患者，後者是醫生，而二者畢竟不可能在所有的情況下都保持共同的利益，所以在知情同意和醫療行善原則分別指導下的行為會發生矛盾。由於此二原則並無內在的聯緊，亦無絕對的主次之分，更由於醫療行善是個多層次的道德範疇，而知情同意是個相對單一的道德和法律要求，因此二者之間難以完全吻合便構成了臨牀的醫學倫理學難題。DOWNLOAD HISTORY | This article has been downloaded 19 times in Digital Commons before migrating into this platform.

LANGUAGE NOTE | Document text in Chinese; abstract also in English.具體實踐中的知情同意是一種倫理學技術，注重利用現有的文化傳統、理論資源和法律工具，合理有效地分析問題、解決問題，強調它作為體現對病人基本權利的尊重和調節醫患關係手段的作用。在民主社會，知情同意乃是建立醫患權責餘的必要條件。知情同意來自於醫療活動的自發秩序：醫患雙方通過知情同意活動，明確醫療活動中雙方的權利和責任界限，進行有成效的醫療實踐。知情同意既是對基本人權的尊重，又是確保雙方責任的工具。具體實踐中的知情同意，提供一種促進多種價值觀和平共存、通過學習和對話實現平衡的運行機制，在社會整體利益優先與個人最基本權利不可侵犯的框架下滿足雙方不同的價值需求。臨床“知情同意”活動的目的在於：促進患者自主權的行使；明晰醫療活動中的權責關係，在合法限度內為醫療活動的正常進行提供保護。實踐中追求資訊的“充分”取決於患方要求的“主觀的充分”。臨床醫療活動中，醫方要不斷提高患方知情的充分程度。隨著知情程度的增加，患方自主程度隨之自動上升。目前關於“知情向意”的理論研究中，缺少對知情同意的狀況、分佈及相關因素的實地調查和量化分析，研究多集中在道德、文化理論上，實踐策略的指導意義不強。應當把知情同意視作貫穿於整個臨床醫療活動的一個連續的整體。要關注本社區成員的文化和心理結構的特殊性，從本社區歷史特點出發，建立本社區知情同意情況的常規模式和量化標準。還應當設計臨床知情同意調查制度，作為醫方制定知情同意策略的依據，同時又可作為說明醫療活動發生的真實過程的法律檔。Informed consent is an ethical technique which emphasizes using the existing cultural traditions, theoretical resources and legal instruments to analyze and solve the problems reasonably and effectively. Informed consent can thus play a significant role in adjusting the relationship between patients and physicians. As an ethical technique, it focuses on the method of applying various ethical resources and not simply on the combination of the logical consequence and criteria. In a democratic society, informed consent is a necessary requirement for the right-duty relationship between patients and physicians. Informed consent is seen as a prerequisite obligation to physicians and implies certain rights for patients. Patients and physicians are bound by informed consent so that they are able to "trade" equally. Informed consent is not only a means to confirming the property rights but also a tool of reducing the costs of "trade". In practice, informed consent helps to promote and achieve the peaceful co-existence of pluralistic values. It can do so by learning and having conversations with the other sides so that different parties can satisfy under the framework which gives priority to the total interests of society and guarantees the fundamental rights of individuals.The aims of informed consent in clinical practice are to promote the self-determination of patients and to clarify rights and duties in medical activities. In practice, the sufficiency of information depends on the subjective sufficiency of patients. Physicians should ensure that the patient comprehend the information and follow the appropriate procedure to manage and supervise. The most active method for physician to take is to increase the degree of informational sufficiency. The degree of the patient's self-determination increases accordingly with the increase of informational sufficiency. Their relationship can be described by a curve like "S".The current studies on informed consent in China lack the empirical data from field research. Most studies focus on the theoretical issues of morality and culture. As a result, research results are hardly applicable in clinical practice. Informed consent should a holistic entity in clinical practice. We should pay more attention to the specificity of the cultural and psychological structure of members of every community. We should establish the ordinary model and criteria of informed consent in the particular community. We should also design an applicable and legally-bond system of informed consent to regulate clinical practice.DOWNLOAD HISTORY | This article has been downloaded 13 times in Digital Commons before migrating into this platform.

LANGUAGE NOTE | Document text in Chinese; abstract also in English.隨著人工智能技術在醫療診斷中得到了越來越廣泛的應用，對於其“不透明性”的擔心也日益加重。這種擔心來自人們對人工智能系統的工作機制尚不清楚。在我們還無法知道其内部工作原理的情況下，根據它的診斷對患者進行治療是否可行？本文嘗試從患者知情同意權的角度去論證，應用於醫療診斷的人工智能系統應該更加透明，以避免對患者造成可能的傷害。Since the introduction of artificial intelligence technologies in medical diagnosis, ethical issues have emerged. One of these concerns is the "black box," which can only be seen in terms of inputs and outputs, with no way to understand the AI algorithm. This is problematic because patients, physicians, and even designers do not understand why or how a treatment recommendation is produced by AI technologies. In this paper, I argue that AI technologies should be explained on the grounds that patients have a right to informed consent.DOWNLOAD HISTORY | This article has been downloaded 54 times in Digital Commons before migrating into this platform.

LANGUAGE NOTE | Document text in Chinese; abstract also in English.“患者利益至上”知情同意是當代西方生命倫理學的一個核心概念，在規範臨床醫療實踐中的應用十分廣泛，相關的法規和指引更是層出不窮。隨著自由主義理論和權利觀念在全世界範圍內的流行，中國也開始注意到知情同意原則在臨床實踐中的重要意義，並逐步引入西方的相關規範。然而，大部分規範的制定缺乏對知情同意倫理基礎的考察，對臨床知情同意在中國的實踐也沒有足夠的關注。本文分析作為知情同意的道德基礎，並通過對一線醫務工作人員的訪談，了解臨床知情在中國實踐情況及限制，希望能為相關規範的制定提供一些思路。Informed consent is considered to be one of the most important conceptual developments in contemporary bioethics, and is strongly implicated in the regulation of clinical practices in the West. Over the past decade, the growing prevalence of both liberal arguments supporting individual autonomy and rights-based debates focusing on equality has brought the concept of informed consent into the purview of Chinese legislation pertaining to healthcare and clinical practice. However, most of the laws and regulations are made by Chinese authorities in ignorance of the concept’s ethical groundings. In addition, lawmakers have not taken into account the empirical reality and specific situations of clinical practice in contemporary China. This essay contends that the history of informed consent legislation in China since 1994, exemplified by the recently adopted Article 55 of the Tort Law of the People’s Republic of China, reveals conflicting understandings of the ethical foundation of the notion of informed consent. The essay also presents extensive interviews conducted by the author with four frontline medical practitioners in first-tier cities that demonstrate how their experiences with informed consent are largely shaped by current institutional settings and influenced by traditional Confucian ethical norms, (e.g., an emphasis on interdependence among family members, which requires the doctor to consult with the family rather than the patient). The essay concludes that we must take into serious consideration the Chinese ethical tradition and its unique application in practice when cross-fertilizing the concept of informed consent.DOWNLOAD HISTORY | This article has been downloaded 116 times in Digital Commons before migrating into this platform.