急診病人侵入性檢查及治療同意書簽署人之研究

Who Gives Informed Consent on Behalf of Emergency Patients?

10.6288/TJPH2010-29-01-08

李芳年(Fang-Niarn Lee)

告知後同意 ； 同意書 ； 急診 ； informed consent ； consent form ； emergency department

台灣公共衛生雜誌

29卷1期（2010 / 02 / 01）

65 - 75

繁體中文

Objectives: Informed consent is intended to insure that a patient fully understands the procedures, benefits, and risks involved in a procedure or treatment. Informed consent is necessary not only for ethical and legal reasons, but also to help improve the quality of care and prevent errors. Unfortunately, little is known about who gives informed consent on behalf of patients before a procedure or treatment in an emergency department. This study investigated the signing of informed consent forms by patients or their relatives in such a setting. Methods: We conducted a review of medical records from 252 cases (234 patients) from January to February 2008 in a general hospital's emergency department in Northern Taiwan in order to determine who signed the consent forms for patients about to receive invasive examinations or treatment. Data were analyzed using T-test and MANOVA. Results: In only 81 cases (32.14%) was the consent form signed by the patient. All of the cases who were assigned triage category-I had the consent forms signed by their parents or other legal guardians. Patient under age 20 had the consent forms signed by their parents, while patient over 65 had consent by proxy. Male patients frequently signed the consent forms themselves, while female patients had consent by proxy. Before invasive procedures, patients frequently signed the consent forms themselves. Conclusions: Patients have the right to participate fully in decisions regarding their treatment in order to make decisions that correlate with their personal values. Frequently, this does not happen. Physicians should seek informed consent from patients unless they are incompetent or unconscious.

Objectives: Informed consent is intended to insure that a patient fully understands the procedures, benefits, and risks involved in a procedure or treatment. Informed consent is necessary not only for ethical and legal reasons, but also to help improve the quality of care and prevent errors. Unfortunately, little is known about who gives informed consent on behalf of patients before a procedure or treatment in an emergency department. This study investigated the signing of informed consent forms by patients or their relatives in such a setting. Methods: We conducted a review of medical records from 252 cases (234 patients) from January to February 2008 in a general hospital's emergency department in Northern Taiwan in order to determine who signed the consent forms for patients about to receive invasive examinations or treatment. Data were analyzed using T-test and MANOVA. Results: In only 81 cases (32.14%) was the consent form signed by the patient. All of the cases who were assigned triage category-I had the consent forms signed by their parents or other legal guardians. Patient under age 20 had the consent forms signed by their parents, while patient over 65 had consent by proxy. Male patients frequently signed the consent forms themselves, while female patients had consent by proxy. Before invasive procedures, patients frequently signed the consent forms themselves. Conclusions: Patients have the right to participate fully in decisions regarding their treatment in order to make decisions that correlate with their personal values. Frequently, this does not happen. Physicians should seek informed consent from patients unless they are incompetent or unconscious.

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