新時代的告知說明與同意:突變與進化【本期企劃】 試閱
Mutation and Evolution of Informed Consent in the New Era
二十一世紀科技快速發展,改變了醫療行為,醫療環境越來越科技化、精準化與個人化,「以病人為中心」成了醫學倫理的座右銘,「告知說明與同意」法則亦順應潮流的精準化與個人化。然而,「告知說明與同意」法則有五種突變,部分有了進一步的修正與進化,本文將提出未來的新時代,告知說明的標準、醫療選項的說明、侵入性治療或手術的風險告知亦應個人化。
In the new era of 21 century, artificial intelligence and precision medicine change the clinical practice a lot. That patient-centered becomes the guideline of medical ethics. The informed consent doctrine is also been modified to be personalized and more precision. In Taiwan, there are five mutations derived from the doctrine. Relatives may sign the informed consent while patient is competent. Relatives may also sign to remove life support machines while patient is still treatable. Legal representatives can make decisions against the best interests of the patient. When a woman wants to terminate her pregnancy, she needs the consent of her husband. Rare complications should be informed to the patient or his/her relatives before invasive procedures or surgeries. Some of these mutations are evoluted progressively. Nonetheless, in the era of precision medicines, the content of informed consent should be personalized. Artificial intelligence or some calculators based on big data analyses can be used for risk assessment and alternative options selection. The equipment of the hospital is not the guarantee of quality. However, the successful rate of the operator should be taking into account in risk assessment.
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