Research on the Actual Conditions of Informed Consent in Contemporary America

当代美国知情同意现状研究

• 批准号: 15530317
• 负责人: TAKAGI Kazuyoshi
• 金额: $ 2.24万
• 依托单位: TOHOKU UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2003
• 资助国家: 日本
• 起止时间: 2003 至 2004
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-15530317/
• 关键词: informed consent; contemporary medicine in the USA; revolution of medical thoughts; role of the physician; 現代アメリカ; タルコット・パーソンズ; ラナイ・フォックス

The medical thought has received the great revolutionary change at the 70's of American society. People questioned the arbitrary paternalistic power of physicians and insisted the rights of self-determinations as well as repudiate doctors treat patients as the objects of manipulation. These situations I named 'the revolution of medical thoughts'.The aims of this research are to analyze the actual conditions on how physicians and patients are pursuing the informed consent in the contemporary United States, and to make clear the course of these development toward the 21st. century. For that sake I tried to do the participant observation and some interviews with medical people and patients at the Massachusetts General Hospital, Medical Hospital of Georgetown University, and Medical Hospital of San Francisco State University, as well as to analyze huge materials of study reports I have collected.As the results of these field researches I can confirm the following points. (1)The informed consent is institutionalized firmly and is conducted actually. (2)Many such professions other than physicians as bioethicists, medical sociologists, medical social workers, psychologists take part in at the hospitals of the United States. (3)People consider the informed consent is not the duties of only physicians also the duties of all medical professions as well as patients. (4)The informed consent is necessary even though patients are children or mentally handicapped persons, for not only family members but also patients themselves. (5)For the sake of that, medical people inform patient's medical situations to themselves undurstandablly by using videos, pictures, many kind of panels. (6)Many hospitals have manuals of informed consent.In general doctor-patient relationship was changed dramatically and doctor's paternalistic despotism was disappeared because American medical world has experienced 'the revolution of medical thoughts'.

医学思想在70年代美国社会发生了巨大的革命性变化。人们质疑医生专断的家长式权力，坚持医生的自主决定权，否定医生把病人作为操纵的对象。本研究的目的是分析当代美国医患双方在知情同意方面的实际情况，并明确其向21世纪发展的历程。世纪。为此，我在马萨诸塞州总医院、乔治城大学医学院、旧金山弗朗西斯科州立大学医学院进行了参与式观察和对医务人员和病人的采访，并对收集到的大量研究报告资料进行了分析。作为这些实地研究的结果，我可以证实以下几点。（1）知情同意制度化牢固，并得到切实执行。（2）在美国的医院中，除了医生之外，还有许多其他职业，如生物伦理学家、医学社会学家、医学社会工作者、心理学家等。（3）人们认为知情同意不仅是医生的义务，也是所有医疗专业人员和患者的义务。（4）即使病人是儿童或弱智人士，知情同意也是必要的，不仅是对家属，而且对病人本身。（5）为了达到这一目的，医务人员通过视频、图片、各种面板等方式，将病人的医疗情况不直观地告知自己。（6）许多医院都有知情同意手册。总体而言，美国医学界经历了“医学思想革命”，医患关系发生了巨大变化，医生的家长式专制消失了。

项目成果

The Science of Man in Social Welfare

社会福利中的人的科学

• 发表时间: 2004
• 作者: KUBOTA Kyoko;TAKAGI Kazuyoshi eds.
• 通讯作者: TAKAGI Kazuyoshi eds.

社会学のすすめ-医療社会学を例として

社会学推荐——以医学社会学为例

• 发表时间: 2003
• 期刊: 人文社会科学の新世紀(原研二他編)(東北大学出版会)
• 作者: Shimada Tatsumi;Kiyoshi Ushida;高城 和義
• 通讯作者: 高城 和義

高齢者役割をどう規定するか

如何界定老年人的角色

• 发表时间: 2004
• 期刊: 福祉の人間学(窪田暁子・高城和義編)(勁草書房)
• 作者: 島田達巳;久保貞也;佐合紀和;高城 和義
• 通讯作者: 高城 和義

The Possibility of Parsons' Social Theory as a Thought

帕森斯的社会理论作为一种思想的可能性

• 发表时间: 2004
• 期刊: Invitation to the Parsons Renaissance(TOMINAGA Ken'ichi and TOKUYASU Akira eds.)(Keiso Shobo)
• 作者: Kosuga;Masanobu;杉田 聡;Tatsuhiko KATO;TAKAGI Kazuyoshi
• 通讯作者: TAKAGI Kazuyoshi

How can we define the role of aged

如何界定老年人的角色

• 发表时间: 2004
• 期刊: The Science of Man in Social Welfare(KUBOTA Kyoko and TAKAGI Kazuyoshi eds.)
• 作者: 高梠真一;高梠真一;TAKAGI Kazuyoshi
• 通讯作者: TAKAGI Kazuyoshi