Difficult decisions: a critical analysis of consent to high-risk medical procedures

同意是适用于医疗保健的道德基石，也是医疗保健与法律之间关系的核心。虽然没有人会否认征求对高风险医疗程序的同意的重要性，但这在很大程度上取决于这样做的实际方式。通过在患者和他们的医疗保健提供者的参与下研究高风险手术的同意，我们将测试同意的限制，并找到解决这些限制的实际方法。通过这样做，该项目将以一种更好地适应高风险环境中临床实践的意外情况的方式重塑同意过程，在高风险环境中，患者的自主性经常受到损害。由于同意的重新表述将基于高风险临床实践的现实，我们的调查结果将反映相关利益相关者(患者和卫生专业人员)的需求和价值观，并更有可能对患者护理和卫生政策做出重大贡献。该项目还解决了澳大利亚高等法院所承认的医学上普遍存在的关于同意的表述的弱点。最后，这个项目在法律和医学的一个重要重叠领域运作，将展示这些学科如何共同努力，为所有澳大利亚人和澳大利亚社会的利益服务。

Consent is the cornerstone of ethics as applied to healthcare and is central to the relationship between healthcare and the law. Whilst no-one would deny the importance of seeking consent to high-risk medical procedures, much depends on the practical manner in which this is done. By studying consent for high-risk procedures with the participation of patients and their health care providers, we will both test the limits of consent and find practical ways to address those limits. In doing so, the project will re-cast consent processes in a way that better accommodates the contingencies of clinical practice in high-risk settings in which patient autonomy is often compromised. Because this reformulation of consent will be grounded in the realities of high-risk clinical practice, our findings will reflect the needs and values of relevant stakeholders (patient and health professionals) and more likely to make a significant contribution to patient care and health policy. This project also addresses what the High Court of Australia has acknowledged as widespread weaknesses in the common formulation of consent in medicine. Finally this project, which operates in an important area of overlap between the law and medicine, will show how these disciplines can work jointly to serve the interests of all Australians, and Australian society.