披露未披露的信息:是否要求放射技师和医护科学家在被询问时告知临时诊断?

IF 3.3 2区 哲学 Q1 ETHICS Journal of Medical Ethics Pub Date : 2024-07-02 DOI:10.1136/jme-2023-109417
Michal Pruski, Daniel Rodger, James E Hurford
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引用次数: 0

摘要

病人需要获得相关信息才能做出知情同意,这可能需要披露临时诊断。然而,如果病人知道存在相关信息,但选择不索取,则没有义务向病人提供信息。放射诊断技师和医护科学家通常负责确保病人在知情同意的情况下接受他们所进行的检查, 但这些检查是由其他临床医生要求的。在此,我们将研究如果患者在诊断检查的知情同意过程中要求提供转诊临床医生对患者做出的临时诊断,他们是否有责任披露该信息。我们首先考虑了英国法律、专业指南和突出的伦理原则,强调虽然专业实践守则强调了以病人的最佳利益为出发点,但并不要求向病人提供他们在检查中不需要或没有要求的信息。因此,我们建议放射诊断技师和医护科学家采用 "最小必要披露 "框架。这一框架既能履行他们对患者的承诺和真实性原则,又能尊重其专业职责的界限。该框架可确保向患者提供足够详细的信息,使其能够在知情的情况下表示同意,同时使诊断专业人员免于全面披露信息,而这本是转诊临床医生的职责。
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Disclosing the undisclosed: are radiographers and healthcare scientists required to communicate a provisional diagnosis when asked?

Patients need to be given the relevant information to be able to give informed consent, which might require the disclosure of a provisional diagnosis. Yet, there is no duty to give information to a patient if that patient is aware that this information exists but chooses not to request it. Diagnostic radiographers and healthcare scientists are often responsible for ensuring that patients have given informed consent for the investigations they undertake, but which were requested by other clinicians. Here we examine if they have a duty to disclose a patient's provisional diagnosis made by a referring clinician if the patient asks for this information as part of the informed consent process to a diagnostic investigation. We first consider aspects of UK law, professional guidance and salient ethical principles, emphasising that while professional codes of practice highlight the need to act in the patient's best interest, they do not require giving patients information they do not require for the examination or have not requested. We then propose that diagnostic radiographers and healthcare scientists placed in such a position use a 'minimally necessary disclosure' framework. This framework fulfils their commitment to their patient and the principle of veracity, while respecting the boundaries of their professional duties. The framework ensures that enough detail is given to the patient for them to be able to give informed consent, while shouldering the diagnostic professional from making a full disclosure, which is the duty of the referring clinician.

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来源期刊
Journal of Medical Ethics
Journal of Medical Ethics 医学-医学:伦理
CiteScore
7.80
自引率
9.80%
发文量
164
审稿时长
4-8 weeks
期刊介绍: Journal of Medical Ethics is a leading international journal that reflects the whole field of medical ethics. The journal seeks to promote ethical reflection and conduct in scientific research and medical practice. It features articles on various ethical aspects of health care relevant to health care professionals, members of clinical ethics committees, medical ethics professionals, researchers and bioscientists, policy makers and patients. Subscribers to the Journal of Medical Ethics also receive Medical Humanities journal at no extra cost. JME is the official journal of the Institute of Medical Ethics.
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