基於儒家家庭本位思想的知情同意原則的思考

Mingjie Zhao,Xiangjin Kong

doi:10.24112/ijccpm.111529

Abstract

LANGUAGE NOTE | Document text in Chinese; abstract also in English.在具有家庭主義特徵的中國社會文化語境下，儒家家庭本位思想對病人知情同意權的影響是客觀實在。以自由主義和個人主義為理論基礎的個人自主知情同意原則要想在中國本土的醫療實踐中發揮應有作用，突顯家庭在知情同意過程中的主導地位是重要前提。在中國的醫療實踐中，知情同意的模式必須融入中國儒家家庭本位思想，才能更好地發揮其作用。Opinion polls released recently show that the majority of people in China today think that informed consent in medical practice is necessary, with more than half favoring family decision making over individual, autonomous patient decision making. Based on these opinion polls, this essay argues that the liberalism and liberal individualism that emphasize individual autonomy do not square with the Confucian tradition.The essay submits that the “family decision” model is designed to embody Confucian family ethics and maximize the benefit of family involvement in medical decision making. The family model includes both the patient and his or her close family members in the decision making process. The Confucian ethics of humanness (ren) – the highest moral virtue – and filial piety (xiao) – the foundation of all moral virtue – support family as the most appropriate authority for medical decisions. Further, the essay explores how the family as a unit is better positioned to work with the physician at critical moments to protect the interests of the patient. This means that the family, not the patient, is in authority, and that in some cases, it is acceptable for family members to hide “medical information” from the patient with the cooperation of the physician. The essay concludes that the family is, and should be treated as, a significant moral participant in medical decision making.DOWNLOAD HISTORY | This article has been downloaded 99 times in Digital Commons before migrating into this platform.

Highlights

關於“誰為病人手術簽字”的問題,53.7%的人認爲應該是“家屬”,46.3%的人認為應該是“患者本人”。儘管有 49.5%的人認為病人簽署知情同意書是醫院“尊重病人的權利”,但多數人認為 “病人本人簽署知情同意書”對病人具有消極影響,34.3%的人認為 “可能增加病人的疑慮”;37.4%的人認為“影響病人的情緒”;只有 28.3%的人認為“有助於病人增加信心”。
關於“在病情緊急,病人生命存在危險”時,84.2%的人認爲病人或家屬 “ 應尊重醫生的意見 ” , 15.8% 的人認為 “ 仍由病人做主”。
2. 數據 2 《醫學與哲學》2013 年第 2 期刊載“誰在行使患者權利:10777 例手術患者簽字情況分析”一文 2 ,該文對某醫院住院手術病例共

Summary

Introduction

關於“誰為病人手術簽字”的問題,53.7%的人認爲應該是“家屬”,46.3%的人認為應該是“患者本人”。儘管有 49.5%的人認為病人簽署知情同意書是醫院“尊重病人的權利”,但多數人認為 “病人本人簽署知情同意書”對病人具有消極影響,34.3%的人認為 “可能增加病人的疑慮”;37.4%的人認為“影響病人的情緒”;只有 28.3%的人認為“有助於病人增加信心”。關於“在病情緊急,病人生命存在危險”時,84.2%的人認爲病人或家屬 “ 應尊重醫生的意見 ” , 15.8% 的人認為 “ 仍由病人做主”。 2. 數據 2 《醫學與哲學》2013 年第 2 期刊載“誰在行使患者權利:10777 例手術患者簽字情況分析”一文 2 ,該文對某醫院住院手術病例共 (1) 杜治政、趙明杰、孔祥金、秦廴怡:〈中國醫師專業精神的病人一般觀點〉,《醫學與哲學》(人文社會醫學版),2011 年,第 32 卷,第 3 期。

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Conclusion