인폼드 컨센트(Informed Consent)의 법리구조

Informed consent is the process by which a fully informed patient can participate in choices about her health care. It originates from the legal and ethical right the patient has to direct what happens to her body and from the ethical duty of the physician to involve the patient in her health care. The informed consent doctrine is generally implemented through good healthcare practice: pre-operation discussions with patients and the use of medical consent forms in hospitals. However, reliance on a signed form should not undermine the basis of the doctrine in giving the patient an opportunity to weigh and respond to the risk. The most important goal of informed consent is that the patient have an opportunity to be an informed participant in his health care decisions. It is generally accepted that complete informed consent includes a discussion of the following elements: (ⅰ) the nature of the decision/procedure, (ⅱ) reasonable alternatives to the proposed intervention, (ⅲ) the relevant risks, benefits, and uncertainties related to each alternative, (ⅳ) assessment of patient understanding, (ⅴ) the acceptance of the intervention by the patient In order for the patient's consent to be valid, he must be considered competent to make the decision at hand and his consent must be voluntary. It is easy for coercive situations to arise in medicine. Patients often feel powerless and vulnerable. To encourage voluntariness, the physician can make clear to the patient that he is participating in a decision, not merely signing a form. With this understanding, the informed consent process should be seen as an invitation to him to participate in his health care decisions. The physician is also generally obligated to provide a recommendation and share her reasoning process with the patient. Comprehension on the part of the patient is equally as important as the information provided. Consequently, the discussion should be carried on in layperson's terms and the patient's understanding should be assessed along the way. I would like to suggest a step by step method in reviewing the physician breach of his obligation to explain. Although there is still some controversy over the exact scope of facts that the physician must explain. The physician must explain (ⅰ) the specific method of treatment, (ⅱ) matters required for obtaining informed consent or approval from the patient and (ⅲ) financial impact of the treatment. Some of the medical problems that physician confront cannot be solved merely through the application of objective medical knowledge and technology. Some medical problems involve a moral dimension related to the life of the patient. Therefore, physician shoud be interested, not only in medical technologies and techniques, but also in the lives of their patients.