INFORMED CONSENT – RIGHT OR BURDEN
Abstract
Informed consent is legal institute that was introduced in the research area to prevent possible abuses in human research. Almost a century later it was introduced also in general medicine outside the research area. It’s a basic human right to decide about own body and thus also about possible interventions in such body. Fore decisions the quality information is necessary. Co-deciding on the type of medical treatment would result also in better result of such treatment (the patient would be more interested to cooperate in the treatment process). The present practice is that informed consent is mere a part of bureaucratic doctor-patient relation as a mode to prevent possible lawsuits. Taking into account other negative impacts on the patient (sc. nocebo effect) there is a serious question whether informed consent is adequate and fruitful. The submission posts some proposals that improve doctor-patient relationship and give patient real possibility to decide alone how and to what extent he/she would execute his/hers rights as a patient regarding medical treatments.
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References
Maehle AH. Doctors, Honour and the Law: Medical Ethics in Imperial Germany London: Palgrave Macmillan; 2009.
Maehle AH. God’s Ethicist’: Albert Moll and His Medical Ethics in Theory and Practice. Medical history. 2012; 56(02): 217-236.
Vollman J, Winau R. Informed consent in human experimentaton before the Nuremberg code. BMJ. 1996; 313: 1445-1447.
The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. Belmont Report. [Online].; 1978 [dostop 5.1.2016. Dostop na: "http://videocast.nih.gov/pdf/ohrp_appendix_belmont_report_vol_1.pdf;%20http://videocast.nih.gov/pdf/ohrp_appendix_belmont_report_vol_2.pdf" http://videocast.nih.gov/pdf/ohrp_appendix_belmont_report_vol_1.pdf; http://videocast.nih.gov/pdf/ohrp_appendix_belmont_report_vol_2.pdf .
UNCHR. International Covenant on Civil and Political Right. [Online].; 1966 [dostop 7.1.2016. Dostop na: "http://www.unhcr-centraleurope.org/si/pdf/viri/pravni-dokumenti/mednarodno-begunsko-pravo/mednarodni-pakt-o-drzavljanskih-in-politicnih-pravicah-1966.html" http://www.unhcr-centraleurope.org/si/pdf/viri/pravni-dokumenti/mednarodno-begunsko-pravo/mednarodni-pakt-o-drzavljanskih-in-politicnih-pravicah-1966.html .
Bioetika. Splošna deklaracija o bioetiki in človekovih pravicah UNESCO. [Online].; 2010 [dostop 8.1.2016. Dostop na: "https://sites.google.com/site/bioetika2010/home/unesco" https://sites.google.com/site/bioetika2010/home/unesco .
Državni zbor. Konvencija o varstvu človekovih pravic in dostojanstva človeškega bitja v zvezi z uporabo biologije in medicine: Konvencija o človekovih pravicah v zvezi z biomedicino. 1998.
ECHR. Health-related issues in the case-law of the European Court of Human Rights. Thematic reports. Strassbourgh; 2015.
Lukman H. Resnicoljubnost na področju medicinske etike. Revus [Spletna izdaja]. 2010;(13): 11-24.
Schmitz D, Reinacher PC. Informed consent in neurosurgery—translating ethical theory into action. J Med Ethics. 2006;(32): 497-498.
AMA. Opinion 8.082 - Withholding Information from Patients. [Online].; 2006 [Dostop 5.1.2016. Dostop na: "http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion8082.page?" http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion8082.page?
Adorno R. The right not to know: an autonomy based approach. Journal of medical ethics. 2004; 30(5): 435-439.
Laurie G. 3 Privacy and the right not to know: a plea for conceptual clarity. In Chadwick R, Levitt M, Shickle D, editors. The Right to Know and the Right Not to Know: Genetic Privacy and Responsibility. 2nd ed. Cambridge: Cambridge University Press; 2014. 38-51.
Wells RE, Kaptchuk TJ. o tell the truth, the whole truth, may do patients harm: the problem of the nocebo effect for informed consent. The American Journal of Bioethics. 2012; 12(3): 22-29.
Curtis RJ, Burt RA. Point: The Ethics of Unilateral “Do Not Resuscitate” Orders. CHEST. 2007; 132(3): 748-750.
Borsellino P. Limitation of the therapeutic effort: ethical and legal justification for withholding and/or withdrawing life sustaining treatments. Multidiscip Respir Med. 2015; 10(1): 1-5.
Miller FG, Colloca L. he placebo phenomenon and medical ethics: Rethinking the relationship between informed consent and risk–benefit assessment. Theoretical medicine and bioethics. 2001; 32(4): 229-243.
Zech N, Seemann M, Graf BM, Hansen E. [Nocebo effects with the informed consent]. nasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS. 2015; 50(1): 64-69.
St. SALGO v. LELAND STANFORD ETC. BD. TRUSTEES, 317 P.2d 170, 560, 317 P.2d 170. [Online].1957; [dostop 16.1.2016. Dostop na: "http://www.leagle.com/decision/1957714154CalApp2d560_1626/SALGO%20v.%20LELAND%20STANFORD%20ETC.%20BD.%20TRUSTEES" http://www.leagle.com/decision/1957714154CalApp2d560_1626/SALGO%20v.%20LELAND%20STANFORD%20ETC.%20BD.%20TRUSTEES
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