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。

Informed Consent:from Nuremberg to Helsinki

Informed consent is now seen as fundamental to research and clinical ethics. Huge literatures advocate supposedly improved consent requirements. Consenting, it is said, should be more explicit; and consent, it is said, should be more specific. These aims are rarely feasible, since the empirical evidence shows that it is extremely hard, and sometimes strictly impossible, to meet either standard. There is little merit in advocating impractical or impossible requirements for informed consent, or in pretending that they can be met. To argue that informed cannot be the fundamental standard for research or clinical ethics,and is best seen as a way by which patients and research subjects and others can selectively waive others' obligations not to perform invasive or intrusive actions. It provides an important way of adjusting underlying obligations provided both parties to respect the epistemic and ethical norms required for genuine consent transactions.