精神卫生领域行使代理同意的伦理风险及其应对

在精神卫生领域，行使代理同意虽然获得了医学伦理的有力辩护，但同时也存在诸多伦理风险。精神卫生领域行使代理同意的伦理风险主要包括家长主义、至上主义和专制主义三大方面。它的形成与代理同意人性预设“扬善蔽恶”始源缺陷导致的“错位性解读”“非理性旁观”“非理性自信”以及“无原则纵容”等问题紧密相关。推广知情同意能力培训、建构代理同意承诺制、建立代理同意定期检查制是防范和抑制精神卫生领域代理同意伦理风险的针对性措施。

A Study on the Ethical Risk and Its Countermeasures of Executing Agency Consent in Mental Health Field

Although agency consent execution is forcefully defensed by medical ethics in the field of mental health, ethical risks are inevitable. The ethical risks of executing agency consent in mental health field mainly include paternalism, paramountcy and despotism. Their formations are closely related to problems like "dislocation interpretation", "irrational bystander", "irrational self-confidence" and "unprincipled connivance" caused by the original defects named as "good promoted but evil sheltered" of the principle of agency consent's humanity presupposes. In order to prevent and restrain its ethical risks, the pertinence measures such as promoting the training of informed consent ability, constructing the commitment system of agency consent and establishing the regular inspection system of agency consent should be considered.