心理咨询中知情同意的伦理困境与解决途径  

Ethical dilemmas and solutions of informed consent in psychological counseling

作　　者：杨成 张晓爱 倪妮 陈兆阳 张博源[1] YANG Cheng;ZHANG Xiaoai;NI Ni;CHEN Zhaoyang;ZHANG Boyuan(School of Medical Humanities,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学医学人文学院,北京100069

出　　处：《中国医学伦理学》2025年第2期220-226,共7页Chinese Medical Ethics

摘　　要：心理咨询知情同意是来访者开启心理咨询的第一步,知情同意履行的程度和效果是决定心理咨询后续效果和发展的重要因素。通过对心理咨询知情同意的内涵及重要性进行阐述,对心理咨询中知情同意议题的伦理困境作了分类总结,存在缺乏共识、程序保障机制,特殊来访者程序与知情同意原则,线上心理咨询知情同意程序不规范等伦理困境,并提出明确咨询师的释明义务,强化程序性伦理约束,制定针对特殊主体的知情同意特殊规范,加强心理咨询师的伦理教育和能力建设。Informed consent in psychological counseling is the first step for clients to initiate the counseling process,and the degree and effectiveness of informed consent are important factors that determine the subsequent effectiveness and development of psychological counseling.By elaborating on the connotation and importance of informed consent in psychological counseling,the ethical dilemmas of the issue of informed consent in psychological counseling were classified and summarized.There were ethical dilemmas,such as the lack of consensus,procedural guarantee mechanisms,special clients procedures and informed consent principles,as well as non-standard informed consent procedures in online psychological counseling.The paper also proposed to clarify the explanatory obligations of counselors,strengthen procedural ethical constraints,formulate special norms for informed consent for special subjects,and enhance the ethical education and capacity building of psychological counselors.

关 键 词：心理咨询 知情同意 伦理约束 伦理困境 

分 类 号：R-052[医药卫生]