論醫師的說明義務與告知後同意

The Physician's Duty-To-Inform and Informed Consent

李芳年(Fang-Niarn Lee)

《北市醫學雜誌》 7卷1期 (2010/03) Pp. 13-20

https://doi.org/10.6200/TCMJ.2010.7.1.02

摘要

醫師的說明義務由告知後同意衍生而來，告知後同意的意義具有三個層次，一是醫療行為需經病人同意、二是醫師需善盡說明義務使病人充份理解而獲其同意、三是未取得病人的告知後同意，可能構成過失或故意傷害。告知義務的主體除由醫師執行說明外，醫療團隊其他人員亦應本於各該職業範疇及專長，善盡說明義務，對於病人或家屬所詢問之問題，如超越其專業範疇，應轉請負責醫師予以回答。除非有正當理由，醫師若未盡到說明義務，就算有業務上的疏失。以實質上已予說明為必要，若只是請病人或家屬簽署同意書，卻未實質上作必要的說明，就未盡到說明義務，有業務上的疏失。告知是醫師的義務，同意是病人的權利，病人有權利選擇同意或不同意，在醫師的「告知」後，會有病患「同意」或「拒絕」兩種結果。

關鍵字

說明義務 ； 告知後同意 ； 過失 ； 同意書

並列摘要

The physician's duty-to-inform occurs before informed consent is given and has three levels. Firstly, any medical treatment must only happen after the patient has given consent. Secondly, the doctor needs explain the treatment in a friendly manner that allows the patient to gain sufficient understanding to make the agreement a valid one. Thirdly, if the patient's consent is not obtained, then any treatment constitutes possible negligence and/or battery. Fully informing the patient is the main duty of the doctor when obtaining an informed consent. Unless there are valid reasons, if doctor does not fully inform the patient, then there is negligence. It is essential to fully explain any procedure to the patient in order to obtain informed consent. If the doctor only invites the patient or family to take part in the procedure and the consent letter is signed without fully explaining the procedure, then no informed consent is obtained. The duty-to-inform is a doctor's duty and agreement or non-agreement is patient's right. The patient has complete freedom to choose to agree or disagree. Physicians do not ”inform” the patient in order to obtain the consent of the patient, but rather the task is help the patient ”choose” based on the doctor's information. After doctor has informed the patient, then that person can either ”agree” or ”refuse”, which are two distinct legal results.

並列關鍵字

Duty-to-inform ； informed consent ； negligence ； letter of consent