Values and the Doctors' Obligation to Inform
Keywords:醫生告知義務, 告知承諾（知情同意）, 價值分析
LANGUAGE NOTE | Document text in Chinese; abstract also in English.
The doctors' obligation to inform means that the doctor shall inform the patient of related information on diagnosis and treatment. Specifically, it includes the following three aspects: 1) Explanation of diagnosis, that is, the explanation made by the doctor about the health condition of the patient according to medical diagnosis; 2) Ex-planation of measures used in invasive diagnosis-both preliminary and final-and treatment plan according to the diagnosis; 3) Explanation of neither diagnosis nor treatment, that is, explanation on why no diagnosis and treatment are available due to the insufficient professional skills of the doctor or lack of medical equipments.
In the doctor-patient relationship, the doctor's obligation to inform reflects the feature of independence, subjectivity, rights, self- determination, and autonomy of the patient. The aim of medical treatment is to cure illness and save the life of the patient so that medical activities should be patient-centered, and respect the patient. To treat patient as equal is the prime ethical requirement for a doctor. Legally, the doctor's obligation to inform reflects the common rule of the doctor's good conducts. It is an important component in diagnosing and treating. In addition, it plays an important part in fulfilling the responsibility of the doctor. Whether the doctor has performed obligation to inform should be taken as important evidence in judging whether a medical error has occurred. If harms to the patient or delay of treatment happen due to the doctor's insufficient or inappropriate explanations about the risks of invasive diagnosis measures and treatment schedule, the doctor should take the responsibility of tort or harm compensation for his or her failure in informing. Reflecting the change of modern medicine from a bio-medical model to a bio-psycho- socio model, to inform the patient fully will help the patient gain an all-around and correct knowledge about his or her illness and take an active role in treating the disease. The process of informing is also a process of medical and health care education. To inform the patient fully will help to establish and maintain a good, reasonable and harmonious doctor-patient relationship.
What should be noted is we should give close attention to the conflicts of various values in informed consent, including social and individual interests and duties to inform the patient and to protect the others. Acknowledging and ranking these conflicting values is thus important. Generally speaking, when patient's autonomy conflicts with public interests, the patient's autonomy should be limited by public interests. When the patient's autonomy endangers his own health and life, the protection of the patient's health and life will be the prime value. Protective treatment is an important rule of medical ethics and legal obligation. But the practice of protective treatment will deprive the patient's autonomy and individuality as it relieves the patient's suffering. Nevertheless, protective treatment is a reality and the solution to the problem will only depend on the careful discretion of the doctor.
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Copyright (c) 2002 International Journal of Chinese & Comparative Philosophy of Medicine
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