이카루스의 꿈: 충분한 설명에 근거한 동의는 실체적인가?

초록

Informed consent has served as a device to ensure the patient's right to self-determination and to check doctors' arbitrary medical practices in medical practice. Recently, however, informed consent tends to be excessively abused. In order for informed consent to become a practical justification factor, informed consent based must be possible in realistic decision-making. Valid informed consent requires some elements: (1) some agreed information among medical practitioners, (2) medical practitioners have to objectively recognize such information, (3) medical practitioners have to objectively explain the information to the patient, (4) patient has to listen to and understand the medical practitioner's explanation, (5) patient should consider the information he/she has accepted in light of his/her own value system, (6) patients should make decisions as a result of such consideration, (7) patients should express his/her decision to medical practitioners, and (8) medical practitioners understand and respect patient’s decision. Individual epistemic ability are formed by innate abilities and experiences, and some epistemic ability are not shared with others when that experience is a transformation experience. The epistemic ability related to an individual's subjective experience also affects the individual's value system. Therefore, individual decision-making is bound to be subjective decision-making, and the process of informed consent also affects subjective epistemic ability and cognitive ability and value system. Informed consent is a type of shared decision-making processes between doctors and patients. However, there is a very high possibility of errors in the process. Errors in the shared decision-making process are influenced by differences in participants' cognitive and understanding skills, different uses of the same words. In addition, it is influenced by participants' and/or medical practitioners’ prejudices and social structures, and testimonial injustice. Informed consent has a procedural meaning. Those who participate in the shared decision-making process take responsibility and pride in that decision> In addition informed consent prevents the action by arbitrary decision. It is time to find the right place for informed consent.

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