关于知情同意的伦理与法律意义之辨析

尊重和自主是知情同意的伦理底线,行善是知情同意的伦理基础.知情同意并不是评判医疗行为是否符合伦理的金标准.伦理上的知情同意与法律上的知情同意,既有区别又相互联系,德法并济是有效履行知情同意的前提.     

注重全人群、全方位、全过程——论受试者知情同意伦理审查的强化

通过对医药学研究人体试验受试者知情同意的伦理审查发展现状的说明,分析现阶段知情同意伦理审查工作中存在流于形式,审查结果不够科学、客观和公正等问题。再结合医药学研究的发展需要,说明知情同意伦理审查的工作情况和不断发展的要求。提出对知情同意做到全人群、全方位、全过程的伦理审查的覆盖。并通过实施全人群、全方位、全过程的伦理审查的过程,提高人体试验受试者知情同意伦理审查水平,促进医药学研究和社会医学的发展。     

医疗知情同意的法伦理思考

医疗知情同意是一项伦理原则,也是一项法律原则.虽然不同视角下的医疗知情同意具有相对不同的要求,但两者在本质上是一致的.尊重患者的知情同意权是患者和社会对医方所提出的要求,也是医方应尽的法律和伦理义务.因此,从法伦理视角审视知情同意原则,以凸显其丰富的内涵及其情、理、法的融合与统一.     

医疗知情同意的法伦理思考

医疗知情同意是一项伦理原则,也是一项法律原则。虽然不同视角下的医疗知情同意具有相对不同的要求,但两者在本质上是一致的。尊重患者的知情同意权是患者和社会对医方所提出的要求,也是医方应尽的法律和伦理义务。因此,从法伦理视角审视知情同意原则,以凸显其丰富的内涵及其情、理、法的融合与统一。     

知情不同意社会心理因素分析——全国10城市4000名住院患者问卷调查研究报告之九

如何对待病人的知情不同意,是履行知情同意时必须正确对待的问题,也是临床医生经常面对的伦理难题.通过问卷调查,了解目前我国病人及家属知情不同意的现状,并对知情不同意社会心理因素进行分析,找出知情不同意的社会心理原因,从而为保护患者的利益,减少医患冲突提供参考依据.     

基因研究中的知情同意之惑

知情同意作为生命伦理的重要原则,在基因研究中同样占据重要的地位,由于基因研究中知情同意的异质性,在基因研究中面临着诸如如何理解其知情同意的异质性、群体知情同意、基因知情与基因隐私、利益冲突等问题。通过分析基因研究中知情同意的特殊性,综合国内外此领域的已有研究,运用理论联系实际的方法,得出结论认为,只有正确区分基因知情与基因隐私的权利主体,用伦理规范来解决利益冲突,在发展中不断完善知情同意,才能够取得科技与伦理的共赢。     

基因研究中的知情同意之惑

知情同意作为生命伦理的重要原则,在基因研究中同样占据重要的地位,由于基因研究中知情同意的异质性,在基因研究中面临着诸如如何理解其知情同意的异质性、群体知情同意、基因知情与基因隐私、利益冲突等问题.通过分析基因研究中知情同意的特殊性,综合国内外此领域的已有研究,运用理论联系实际的方法,得出结论认为,只有正确区分基因知情与基因隐私的权利主体,用伦理规范来解决利益冲突,在发展中不断完善知情同意,才能够取得科技与伦理的共赢.     

大数据时代的知情同意

《纽伦堡法典》之后,知情同意原则逐渐成为世界医学界公认的保护患者和受试者权利的伦理原则。医学的发展离不开大数据的共享,也对知情同意原有模式提出了挑战。分析知情同意产生、发展以及在大数据时代面临的危机,在此基础上进一步分析数据挖掘与使用中的伦理问题,并探讨医学发展与知情同意原则维护之间的关系。最后在对当前学界研究进展进行综述的基础上,提出建立新型知情同意模式的必要性。     

医生的特殊干涉:面对患者及其家属的知情不同意的伦理选择

在医疗活动中,医疗机构与医务人员面临着患者及其家属的知情不同意,分析了导致知情不同意的可能原因,论证了面对危及患者生命的知情不同意时医生行使特殊干涉权的合乎伦理性,并提出了行使特殊干涉权的具体做法。     

心理咨询和治疗的知情同意原则及其影响因素

随着心理咨询和治疗的发展,患者的知情同意成为临床心理学实践的一个基本伦理观念和原则。首先提出心理咨询和治疗实践中的知情同意问题,介绍心理咨询和治疗知情同意的要素、过程、内容、意义和影响因素,并附心理咨询和治疗提供给患者的知情同意问卷,旨在引起从业者的注意和重视,并在临床实践中自觉地遵守。     

Ethical Implications of User Perceptions of Wearable Devices

Health Wearable Devices enhance the quality of life, promote positive lifestyle changes and save time and money in medical appointments. However, Wearable Devices store large amounts of personal information that is accessed by third parties without user consent. This creates ethical issues regarding privacy, security and informed consent. This paper aims to demonstrate users’ ethical perceptions of the use of Wearable Devices in the health sector. The impact of ethics is determined by an online survey which was conducted from patients and users with random female and male division. Results from this survey demonstrate that Wearable Device users are highly concerned regarding privacy issues and consider informed consent as “very important” when sharing information with third parties. However, users do not appear to relate privacy issues with informed consent. Additionally, users expressed the need for having shorter privacy policies that are easier to read, a more understandable informed consent form that involves regulatory authorities and there should be legal consequences the violation or misuse of health information provided to Wearable Devices. The survey results present an ethical framework that will enhance the ethical development of Wearable Technology.     

知情同意：从纽伦堡到赫尔辛基

知情同意被视为临床伦理学与研究伦理学的基本原则。大量的文献倡导提高同意的必要条件。据说,同意应当更加明确、具体。经验主义的证据显示,满足任何一方标准是极其困难的,有时是不可能的,因此,这些目标很难行得通。倡导知情同意不实际与不可能的要求,有极小的价值。讨论告知不能作为临床伦理学与研究伦理学的基本标准,知情同意可以最好视为病人与受试者以及其他人所能选择性放弃其他的义务,而不采取侵害性行为的一种方法。它提供了一种调节根本的义务的重要方式,这一义务是由尊重真正执行同意所需要的伦理标准与认识力的双方提供。     

关于胚胎干细胞研究的一场伦理之争

关于“人兔细胞融合”的伦理之争,主要围绕“人兔细胞融合”实验是否违背伦理,要不要经过知情同意,以及科学技术与伦理道德的关系等问题而进行。这场讨论是正常的,健康的,有益的,倘能加以认真总结,将有助于推进学术争鸣。     

Rethinking research ethics

Contemporary research ethics policies started with reflection on the atrocities perpetrated upon concentration camp inmates by Nazi doctors. Apparently, as a consequence of that experience, the policies that now guide human subject research focus on the protection of human subjects by making informed consent the centerpiece of regulatory attention. I take the choice of context for policy design, the initial prioritization of informed consent, and several associated conceptual missteps, to have set research ethics off in the wrong direction. The aim of this paper is to sort out these confusions and their implications and to offer instead a straightforward framework for considering the ethical conduct of human subject research. In the course of this discussion I clarify different senses of autonomy that have been confounded and present more intelligible justifications for informed consent. I also take issue with several of the now accepted dogmas that govern research ethics. These include: the primacy of informed consent, the protection of the vulnerable, the substitution of beneficence for research's social purpose, and the introduction of an untenable distinction between innovation and research.     

Rethinking research ethics

Contemporary research ethics policies started with reflection on the atrocities perpetrated upon concentration camp inmates by Nazi doctors. Apparently, as a consequence of that experience, the policies that now guide human subject research focus on the protection of human subjects by making informed consent the centerpiece of regulatory attention. I take the choice of context for policy design, the initial prioritization of informed consent, and several associated conceptual missteps, to have set research ethics off in the wrong direction. The aim of this paper is to sort out these confusions and their implications and to offer instead a straightforward framework for considering the ethical conduct of human subject research. In the course of this discussion I clarify different senses of autonomy that have been confounded and present more intelligible justifications for informed consent. I also take issue with several of the now accepted dogmas that govern research ethics. These include: the primacy of informed consent, the protection of the vulnerable, the substitution of beneficence for research's social purpose, and the introduction of an untenable distinction between innovation and research.     

Forensic standards in the American Psychological Association's new ethics code

The 1992 revision of the American Psychological Association's ethics code includes, for the first time, a section devoted to forensic issues. This article examines the adequacy with which the Forensic Activities section addresses fundamental ethical issues inherent in forensic practices (i.e., being competent in forensic practice, dealing with requests for service, providing informed consent, providing services, and reporting findings). We conclude that the ethics code modestly addresses important forensic ethical issues and that it too often is characterized by inconsistencies, insufficient information, omissions, and the inappropriate application of the term forensic to general standards not uniquely related to forensic practice.     

Ethics and the professional practice of psychologists: the role of virtues and principles

We evaluate the potential relevance of virtue ethics to the training and practice of professional psychologists, and we contrast them with principle ethics. Typically, principles are used to facilitate the selection of socially and historically acceptable answers to the question "What shall I do?" when confronted by ethical dilemmas. Virtue ethics, however, generally focus on the question "Who shall I be?" Strengths and weaknesses of each approach are presented. The impact of each is discussed with respect to informed consent and the therapeutic construct "genuineness." We conclude that virtue ethics are an essential component of responsible ethical training and practice.     

对外科急腹症诊疗中伦理学矛盾的探讨

由于外科急腹症的特殊性,产生了与其他科室不同的伦理学矛盾。本文探讨了急腹症诊疗中存在的伦理学矛盾和相应对策。在急腹症诊疗过程中,要重视伦理学矛盾产生的原因,完善急腹症诊疗中存在的流程问题,自觉实践医学伦理学的知情同意原则,有助于化解医患矛盾,减少医疗纠纷;同时也要减轻医生工作压力,加强团队合作精神。     

Elliott’s Ethics of Expertise Proposal and Application: A Dangerous Precedent

In a recent paper in Science and Engineering Ethics (SEE) Elliott proposed an ethics of expertise, providing its theoretical foundation along with its application in a case study devoted to the topic of hormesis. The application is based on a commentary in the journal Nature, and it includes assertions of ethical breaches. Elliott concludes that the authors of the commentary failed to promote the informed consent of decision makers by not providing representative information about alternative frequency estimates of hormesis in the literature, thereby hindering the capacity of the scientific community to promote informed consent relating to chemical regulation. This paper argues that Elliott should have incorporated due process into his system of evaluation. His argument is also seriously deficient technically, in that it misinterprets the toxicological issues, misrepresents the scientific literature with respect to the frequency of hormesis, and incorrectly assesses the extent to which the Nature paper revealed opposing/alternative views on hormesis. Given the seriousness of assertions of noncompliance to ethical norms, there must be procedures to protect those whose ethics were called into question, to fairly evaluate the technical justification for an assertion, and to enable corrections in the event of errors. If a journal is willing to publish assertions that individuals acted in an ethically questionable way, it should be guided by a documented code of ethics and meet a standard of responsibility far greater than normal peer-review processes for papers that do not entail such ethical judgments.     

Attitude change in marital cotherapy

Abstract

Ethical and legal issues concerning the application of informed consent in psychotherapy are reviewed in relation to: 1) controversies in defining an informed consent; 2) ethical and legal responsibilities of a psychotherapist in obtaining an informed consent; 3) potential ethical and legal liabilities for not implementing the informed consent doctrine; and 4) principles of confidentiality and privileged communication as they apply to this doctrine. Suggestions are made on how to implement an informed consent legally and ethically in psychotherapy.