精神障碍患者麻醉知情同意的临床伦理分析  

Clinical Ethical Analysis of Informed Consent to Anesthesia in Patients with Mental Disorders

作　　者：黄明涛 刘永潇 莫楠[2,5] HUANG Mingtao;LIU Yongxiao;MO Nan(The School of Health Management,Fujian Medical University,Fuzhou 350004,China;Medical Humanities Research Center,Fujian Medical University,Fuzhou 350004,China;Department of Anesthesiology,Ningde Municipal Hospital of Ningde Normal University,Ningde,Fujian 352100,China;Department of Anesthesiology,The First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China;The School of Marxism,Fujian Medical University,Fuzhou 350004,China)

机构地区：[1]福建医科大学卫生管理学院,福州350004 [2]福建医科大学医学人文研究中心,福州350004 [3]宁德师范学院附属宁德市医院麻醉科,福建宁德352100 [4]福建医科大学附属第一医院麻醉科,福州350005 [5]福建医科大学马克思主义学院,福州350004

出　　处：《协和医学杂志》2023年第2期437-441,共5页Medical Journal of Peking Union Medical College Hospital

基　　金：福建省教育科学“十四五”规划课题“医学生医学人文教育中情元素的培育研究”(FJJKBK21-107);福建省社会科学规划一般项目“疫情防控中信息弱势群体的伦理问题研究”(FJ2022B147);福建医科大学医学人文研究中心开放课题“弱势群体麻醉知情同意的伦理问题研究”(RW202208)。

摘　　要：在临床实践中,麻醉技术的知情同意仍是麻醉学科的独特领域,但麻醉科医生轻视精神障碍患者的知情同意成为临床工作的薄弱环节。在人类原始道德本能的加持下,基于对精神障碍患者同情的道德关怀,代理同意被认为有利于患者,但现实中存在多种因素制约患者在麻醉知情同意上享有权利。在医患共同决策医学模式下,应尽可能让轻症精神障碍患者参与知情同意过程,其提供信息的深度和广度取决于患者的自知力。获取精神障碍患者麻醉知情同意的路径尚待优化,可通过多学科合作等多种方式,达到患者真正知情同意,保障精神障碍患者的合法权益。In clinical practice,informed consent to anesthesia technology is still a unique field of anes⁃thesiology.For patients with mental disorders,anesthesiologists􀆳neglect of the process of informed consent has become a weak link in clinical work.With the primitive moral instinct of humans and based on sympathetic moral care for patients with mental disorders,proxy consent is considered to be beneficial to patients,but in reality,there are many factors that restrict their rights in anesthesia informed consent.In the medical model of doctor⁃patient joint decision⁃making,patients with mild mental disorders should be involved in the informed consent process as much as possible,and the depth and breadth of the information provided depend on the patient’s insight.The path to truly obtaining informed consent for anesthesia from patients with mental disorders needs to be optimized.Through multi⁃disciplinary cooperation and other methods,we can achieve real informed consent and protect the rights of patients with mental disorders。

关 键 词：知情同意 麻醉知情同意书 精神障碍患者 患者自主权 信息告知 

分 类 号：R749[医药卫生—神经病学与精神病学] R-052[医药卫生—临床医学]