整形美容手术中知情同意的伦理探讨

目的 明确知情同意在整形美容行业中的必要性和重要性,探讨其中隐藏的伦理学意蕴,用知情同意这一重要的伦理原则规范医务人员的行为.方法 使用文献检索法、专家咨询法、抽样调查等方法对整形美容手术中的知情同意情况进行调查,分析实施过程中的规范化情况和遇到的难点和伦理困境.结果 整形美容医师牢牢把握了知情同意这一原则,作为术前常规工作执行,但在实际操作过程中还有些难点.结论 整形美容医生应规范履行知情告知义务,尊重患者的知情权;院方须制定一系列的制度来规范知情同意这一原则.     

重视知情同意 减少医疗纠纷

探讨了医务人员对不同患者、不同病种应告知的内容、事项、告知方式等问题。在医疗活动中,医务人员应履行告知义务,保障患者的知情同意权。只有重视知情同意,执行和落实知情同意制度,加强医患沟通,才能保证医疗安全,减少因知情同意告知不全而引发的医疗纠纷。     

护士落实义务告知的做法

目的 对患者知情同意的内容，予以义务告知。方法明确护士义务告知范畴，予以分段告知。结果护士们能主动运用法律手段维护护患双方合法权益，患者对护理治疗工作能知情同意。结论有效的保障措施和合适的工作流程，能使护士规范落实法定责任，有助建立互动参与型的护患关系。     

护理告知及知情同意制度在防范护患纠纷中的效果研究

目的：对患者落实护理告知、知情同意制度,以达到减少护患纠纷的目的。方法：选取住院患者1000例,随机分为实验组690例及对照组310例。实验组在入院后,对患者进行4个主题的护理告知、知情同意。对照组按常规进行入院宣教。结果：实验组共发生护患纠纷32例,对照组共发生护患纠纷59例。结论：护理告知、知情同意制度的落实,可减少护患之间冲突,降低护患纠纷的发生率。     

急危患者知情不同意的医疗处置研究

知情不同意是患者行使知情同意权的一种结果,医务人员应尊重患者知情不同意的权利.患方的知情不同意决定可能危及患者生命.急危情况下,患者本人尤其是其代理人的不同意决定危及患者生命时,患者的知情同意权应让位于其生命权.法律应赋予医务人员紧急救治权,患方不能以其不同意为由要求医务人员对此后果承担法律责任.     

维护患者知情同意权对减少护理工作中医疗纠纷的意义

本文通过对医疗纠纷、知情同意权含义的了解,分析护理工作中医疗纠纷发生的原因,并提出相关防范对策.文章充分论证和说明维护患者的知情同意权,可以促进护理过程中的护患沟通,改善护患关系,提高整体护理质量,增强护患双方的法律意识,从而有利于减少护理工作中的医疗纠纷.     

论知情同意制度的不足以及术中改变术式的法律责任

知情同意制度贯穿于医疗活动的整个过程,尊重患者的知情同意权是医务人员的法定义务,国内诸多法律法规均对医疗活动中的知情同意做了原则性的规定。但是由于缺乏针对具体医疗行为如何适用知情同意制度的指引或者规范,导致医务人员常常不知如何正确的地履行知情同意程序。而且．当前的知情同意制度存在诸多不足,司法实践也对知情同意缺乏深入的研究．这为医务人员的执业活动带来了潜在的法律风险。     

应该重视生物医学期刊稿件中的医学伦理学问题

讨论了目前我国生物医学期刊涉及最多的生物医学研究中的受试者“知情同意”问题、干细胞研究中的伦理学问题和保护患者(或受试者)隐私权的问题。指出生物医学期刊工作者应该重视来稿中所涉及的医学伦理学问题。提出生物医学期刊在或受试者“知情同意”问题上应注意的几个问题,对干细胞研究中一些伦理学问题的观点,及保护患者(或受试者)隐私权的具体做法。     

临床医学科研中的知情同意之我见

结合临床医学科研伦理管理中的经验,对知情同意的要素、知情同意的方式、知情同意的主体、知情告知的主要内容、知情告知的过程、知情同意书的签署、知情同意书的保存等方面进行了探讨,提出了一些见解、体会和经验,供广大医学科学研究工作者和医学科研管理人员参考.     

《侵权责任法》医疗知情同意实践问题研究

结合〈侵权责任法〉中关于医疗知情同意的具体医疗实践,明确了肇事司机不可以为受伤者签署知情同意书,＂三无＂患者知情同意应由本人签署,以及患者签署授权委托书等问题,为医疗机构正确行使知情同意提供法律依据.     

《侵权责任法》实施背景下护理安全管理的思考

在《侵权责任法》实施背景下,阐述对护理安全管理现实意义的基础上,分析未尽到临床护理中的注意义务和执行诊疗护理常规;未完善病历的全程质量监督机制;未完全履行护士的说明义务以保障患者的知情同意权;存在侵犯患者隐私权的行为;药品、消毒药剂、一次性医疗器械的管理欠规范等护理安全在《侵权责任法》对其规定方面存在的问题,并提出相应对策。     

Informed consent and the history of inclusion of women in clinical research

The purposes of this paper are to (a) discuss the troubled history of informed consent for research on women and its ramifications for women's participation in clinical trials; (b) interrogate current informed consent practices as to their accountability and justice in the treatment of women; and (c) recommend to nurse researchers and clinical nurses ways of improving the practice of informed consent in research with women.     

INFORMED CONSENT AND THE HISTORY OF INCLUSION OF WOMEN IN CLINICAL RESEARCH

The purposes of this paper are to (a) discuss the troubled history of informed consent for research on women and its ramifications for women's participation in clinical trials; (b) interrogate current informed consent practices as to their accountability and justice in the treatment of women; and (c) recommend to nurse researchers and clinical nurses ways of improving the practice of informed consent in research with women.     

阴道镜下宫颈组织活检术的护理配合及健康教育

目的研究护理配合及健康教育对阴道镜下宫颈组织活检术的影响。方法选取我院妇科门诊2009年1月～2010年10月450例因宫颈组织学异常或可疑癌在知情同意后行阴道镜检查及定位下活检作为研究对象,内容包括检查前交代注意事项及心理护理、检查中的护理配合、检查后的健康教育三个方面。结果病人均能消除恐惧心理配合检查。结论护理配合及健康教育是阴道镜检查下宫颈组织活检术顺利完成的保证。     

Factors affecting rapid turnover of novice nurses in university hospitals

Rapid turnover of novice nurses eventually results in a shortage of veteran nurses. This study aimed to clarify the factors affecting rapid turnover of novice nurses in a prospective manner. We carried out an investigation in 20 university hospitals whose directors of nursing service departments accepted our request to cooperate with our research program. These hospitals were selected from all of the 102 university hospitals listed in The Hospital Catalog of Japan. The subjects were 1,203 novice hospital nurses who gave their informed consent for participation in our study. The questionnaires, which dealt with burnout, assertiveness, stressful life events, reality shock, ward assignment preference, transfer preference, job satisfaction (workplace, salary, workload, and overtime), social support and coping mechanisms were completed by 923 novice nurses in June 2003. Then, their turnover was investigated in December 2003. Thirty-seven novice nurses (4.0%) quit during this period. Multiple logistic regression analysis showed that the factors affecting rapid turnover were 1) graduation from vocational nursing schools, 2) dissatisfaction with assignment to a ward contrary to their desire, and 3) no peers for support. Assignment of novice nurses to wards they choose as far as possible, avoidance of assigning novice nurses to wards alone, and establishment of a support system for nurses who graduate from vocational nursing schools seem to be important for preventing rapid turnover of novice nurses.     

浅谈医事法学视野下知情同意权的制度研究

知情同意权是医患关系的一项重要内容,它既是患者的权利,同时也是医生的义务.医疗知情同意的实现,有助于增进医患之间和谐的关系.要确保知情同意权的有效实现,不仅需要医患双方对知情同意的深入理解和正确认识,还需要相应的法律制度做保障.     

Best practice guidelines on informed consent for weight loss surgery patients

OBJECTIVE: To provide evidence-based guidelines on informed consent and the education that underlies it for legally competent, severely obese weight loss surgery (WLS) patients. RESEARCH METHODS AND PROCEDURES: We conducted a systematic review of the scientific literature published on MEDLINE between 1984 and 2004. Three articles focused on informed consent for WLS; none was based on empirical studies. We summarized each paper and assigned evidence categories according to a grading system derived from established evidence-based models. We also relied on informed consent and educational materials from six WLS programs in Massachusetts. All evidence is Category D. Recommendations were based on a review of the available literature, informed consent materials from WLS programs, and expert opinion. RESULTS: This Task Group found that the informed consent process contributes to long-term outcome in multiple ways but is governed by limited legal requirements. We focused our report on the legal and ethical issues related to informed consent, i.e., disclosure vs. comprehension. Recommendations centered on the importance of assessing patient comprehension of informed consent materials, the content of those materials, and the use of active teaching/learning techniques to promote understanding. DISCUSSION: Although demonstrated comprehension is not a legal requirement for informed consent in Massachusetts or other states, the members of this Task Group found that the best interests of WLS patients, providers, and facilities are served when clinicians engage patients in active learning and collaborative decision making.     

药物临床研究中痴呆受试者知情同意过程探析

目的为我国痴呆药物临床研究受试者知情同意的规范化提供参考依据。方法对近年来我院关于痴呆药物的临床研究知情同意过程中所存在的问题及其原因进行分析,探究其解决方法。结果随机双盲安慰剂对照研究或针对中重度痴呆患者的研究中,受试者及其知情者的知情同意过程困难,不良事件发生率高,反之随机双盲阳性药对照或轻度痴呆患者的研究上述情况则较少出现。结论建议通过对受试者、知情者的健康教育及对研究者的法制教育,构造完善的法律法规保障制度,健全伦理委员会监督机制等措施来保护受试者及其知情者的权益。