知情同意与公共卫生

Q4 Medicine Jahr Pub Date : 2023-01-01 DOI:10.21860/j.13.2.3
Ivana Tucak, Gordana Pelčić
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引用次数: 0

摘要

知情同意的主要目的是鼓励个别病人和科学研究对象自主作出决定,而公共卫生措施,如强制接种传染病疫苗,其成功意味着对广大人口统一接种疫苗,乍一看似乎是不可调和的对立面。本文探讨的是调查这些对立是否可以调和,或者知情同意是否可以应用于公共卫生领域。本文的第一部分简要概述了知情同意的主要特征及其在治疗个体患者中的相关性。论文的第二部分论述了免疫接种问题。如果没有得到病人的同意或有法律义务,医生被认为在进行疫苗接种时干扰了其他人的身体完整,他们的行为可被视为攻击,并需要非金钱损害赔偿。只有在所有人都平等地接受公共卫生措施的情况下,才能实现群体免疫这一"公益"。在这一点上,关键问题是知情同意和附属决策自由是否对实现这一公共卫生目标构成威胁。这个问题确实应该得到回答,因为接种疫苗虽然很少,但可能导致医疗并发症,从而可能导致高昂的治疗费用、收入损失和极其罕见的死亡。本文的目的是证明,在公共卫生方案框架内披露免疫接种的风险和益处,有助于将基本的生物伦理假设付诸实践:在医生和病人之间建立和促进相互信任,最终有助于提高人口的免疫率。
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Informed Consent and Public Health
Informed consent, which is primarily aimed at encouraging individual patients and subjects of scientific research to make autonomous decisions, and public health measures, such as compulsory vaccination against infectious diseases, the successfulness of which implies harmonized administration of vaccines to a broad population, seem to be irreconcilable opposites at first glance. This paper deals with investigating whether these opposites can reconcile or whether informed consent can be applied in the field of public health. The first part of the paper provides a short overview of the main features of informed consent and its relevance in treating individual patients. The second part of the paper tackles the issue of immunization. If not provided with consent of their patients or having a legal obligation, physicians are believed to interfere with the bodily integrity of other people when conducting vaccination and their act can be deemed as an assault and entail non-pecuniary damage compensation. Herd immunity as a “public good” can only be achieved if all people are equally subject to public health measures. At this point, the key question is if informed consent and appertaining freedom of decision-making represent a threat to the accomplishment of this public health goal. This question should truly be answered since vaccination may, though rarely, bring to medical complications, which may then lead to high treatment costs, loss of income and extremely rare, to death. The purpose of this paper is to demonstrate that disclosure of the risks and benefits of immunization within the framework of public health programmes could contribute to putting the fundamental bioethical postulates into practice: establishing and fostering mutual trust between physicians and their patients, which can, in the end, contribute to a higher immunization rate of a population.
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来源期刊
Jahr
Jahr Medicine-Medicine (miscellaneous)
CiteScore
0.60
自引率
0.00%
发文量
11
审稿时长
20 weeks
期刊介绍: JAHR – EUROPEAN JOURNAL OF BIOETHICS is a journal that deals with a wide range of bioethical topics. The aim of the Editorial Board is to publish articles related to bioethics in social sciences (sociology, psychology, law, political science, information and communication sciences, pedagogy, education and rehabilitation sciences, speech-language pathology, kinesiology, demography, social activities, security and defence sciences, economics), humanities (philosophy, theology, philology, history, art history, archaeology, ethnology and anthropology, religious sciences), biomedical (medicine, public health, veterinary medicine, dentistry and pharmacology), but also in other sciences. The journal is published twice a year.
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