Информированное добровольное согласие пациента: институализация практик в современной России

Abstract

The state has initiated the institutionalization of voluntary consent practices before medical intervention, recognizing that social well-being is a crucial factor in the provision of medical care. Today, informed voluntary consent (IVC) of the patient is being formalized, but the problem of trust in the healthcare system remains. An analysis of social patients' practices shows that consent has not been formalized, and a favorable public opinion about the healthcare system as an institution of trust in the medical system has not yet occurred. The conclusions are based on data from a survey of young people aged 18 to 35 years – patients of medical organizations in St. Petersburg. The sample is multi-stage, with nests (medical organizations) being selected first, followed by a purposeful sample, and the selection criterion for respondents is receiving medical care at the institution during the study period. This article presents an analysis of violations in signing informed consent and the reasons for their occurrence, as well as a patient assessment of the procedure and the IVC document. The obtained findings allow us to state that in order to improve the quality of medical care and increase trust in medical organizations, it is necessary to conduct additional explanatory work on medical interventions in written and accessible form for people who do not have special knowledge and are not familiar with medical and legal terminology. The IVC should have a place for indicating the performer of the medical intervention and special conditions that could be filled in considering the individual characteristics of the patient and the capabilities of the organization providing medical services. In a broader research perspective, it is worth paying attention to the discussion of bioethical documents, which are not always conducted from a conservative position; on the contrary, the principles of bioethics are questioned and new grounds are sought for its modernization; there is talk of "ambiguous ethics" and the impossibility of solving all problems within the framework of institutionalization theory.