Comments On The Patient's Informed Consent Right

Informed consent, as a real right of patients, is the product of economic development and right movement. It has a long history of decision development and rule development. In the 18th and 19th century, there is"informed consent"on primary sense in America, but its purpose is to cooperate with the doctor's diagnoses, not for the honor of patients'human dignity. Not until the trial of doctors in Nuremberg after World Warâ…¡, informed consent became a real right of patients, and was applied widely to medical procedures. In decision development, the right of informed consent went through some evolvements as follows: from lack of consent to lack of informed consent, from doctor standard to patient standard, from sue of battery to sue of negligence. In rule development, there are international legislations, such as Nuremberg Code, Declaration of Helsinki, as well as national legislations, such as Patients'Self-deciding Bill, Patients'Right Bill. These legislations provide gist for the protection of informed consent.The patients'informed consent right consists of two parts of right: one is the right to be informed; the other is the right to consent.Right to be informed means that patients are entitled to know the relevant medical information. According to different periods which a patient is in, there are four types of right to be informed: right to be informed for the necessity of making a valid acceptance promise, right to be informed during medical executions, right to be informed when switching to another medical agency, right to be informed when refusing medical measures. A doctor should obey the materiality standard of disclosure, and tell patients the information which would have effect on patients'medical decision. However, there is some occasions that the right to be informed can't be applied by patients, such as the medical emergency, the medical privilege, patients'discard of their right to be informed, considering about public interest, and so on .The consent right, means that on the base of being sufficiently informed of medical information, patients could make decision autonomously, accept the benefit and danger brought by the medical measures, choose their favorite doctor and medical measure, or refuse any medical measures. When a patient has right cognition, he should make a medical decision by himself. When there is necessity to let another person make decision for the patient, the agent must make decision on the behalf of the patient. A patient can also wield the right of advanced assignment, to make decisions for the medical affairs which may take out in the future. This is a good way of realizing the patient's own will.The consent right consists of right to accept, choose or refuse. In our country, right to accept is mainly embodied as the acceptance of operation. Patients'signature on operation acceptance, only means the operation's enforcement is legal. Doctors should obey their professional standards as well. Right to choose includes two aspects: right to choose hospitals and doctors, right to choose medical steps. Besides, a patient can refuse any medical steps, or require the doctor to end his life beforehand. This will arise the topic of euthanasia. According to our national legislation, the euthanasia practice is illegal. However, there are many conditions where euthanasia is executed in disorder. The euthanasia can relieve pain and protect the human indignity of patient; many countries'legislations have accepted it. We should study the real meaning of humanism, and let euthanasia be executed orderly. Our national legislations also make rules to protect patients'right of informed consent. Such as, Rule of Dealing with Medical Accidents, Professional Doctor Bill, and so on. Fault is a necessary element of the responsibility of offending informed consent. Take tort as the base of sue for this illegal behave, will protect the patient's interest much better, compared with charging for contract offence. If there is fault, damage and causation between them, the liability of offending informed consent can be enquired. There are two points we should take attention to on the indemnity extension: firstly, pay attention to the mental damage indemnity of the patient, and extend the applicable area of mental conciliatory money; secondly, to change the single rule of limited indemnity, and set up a comprehensive medical indemnity system which consists of overall indemnity rule, limited indemnity rule, balanced indemnity rule and punitive indemnity rule.