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首页> 美国卫生研究院文献>Journal of Public Health Research >The protection of health in the care and trust relationship between doctor and patient: Competence professional autonomy and responsibility of the doctor and decision-making autonomy of the patient
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The protection of health in the care and trust relationship between doctor and patient: Competence professional autonomy and responsibility of the doctor and decision-making autonomy of the patient

机译：在医生与患者之间的护理和信任关系中保护健康：医生的能力专业自治权和责任以及患者的决策自主权

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The Authors review Law No. 219/2017, with its important contribution to defining the roles and responsibilities of subjects in care relationship – a dynamic relationship (over time, for the condition of the interested party, to people who may be involved) – and regulating advance directives and shared planning of care. The Law promotes and enhances the relationship of care and trust between doctor and patient, which includes the competence, professional autonomy and responsibility of the doctor and the decisional autonomy and right to self-determination – to make an informed and voluntary choice about treatment proposed by the doctor - of the patient. For concrete implementation of the Law, an adequate information system and all the measures to guarantee certainty about the consequences of behaviour and protection of the rights of all the subjects involved are now essential. In addition, for advance directives, it is essential to reflect on the adequacy of medical information required by the Law itself for its drafting, considering that the citizen can contact qualified professionals and also independently find this information autonomously, selecting the sources of information.Significance for public healthDoctrine, jurisprudence and the most recent legislation in Italy have consolidated the centrality of the individual in the decision-making process for health protection. Even with incapacity, considering "subjective" components is essential to guaranteeing protection of the person while enhancing and promoting autonomy. Law No. 219/2017 does not introduce new principles to those already in the legal system, but makes an important contribution to the helpful and certain implementation of health care by protecting the best interest of the patient and placing the person, their dignity and their self-determination at the centre of the care and trust relationship. The law recognises the patient's freedom to choose therapy, including refusing or renouncing health care and, by defining the boundaries of medical action, increases certainty on the consequences of such action.
机译：作者审查了第219/2017号法律，该法律对定义受试者在照护关系中的作用和责任–动态关系（随着时间的流逝，对于当事人的利益，对于可能涉及的人）具有重要贡献–以及规范事前指示并共享护理计划。该法促进并增强了医患之间的关怀和信任关系，其中包括医生的能力，专业自治权和责任以及决定性自治权和自决权，以便就由病人的医生。为了具体实施该法律，现在必不可少的是，一个适当的信息系统和所有措施，以确保行为后果的确定性和所有相关主体的权利保护。此外，对于提前指示，必须考虑法律本身起草所需的医疗信息的充分性，考虑到公民可以联系合格的专业人员，也可以独立自主地找到该信息，并选择信息来源。公共卫生方面的理论，法理学和意大利的最新立法已经巩固了个人在健康保护决策过程中的中心地位。即使没有能力，考虑“主观”成分对于在增强和促进自治的同时确保对人的保护也是必不可少的。第219/2017号法律没有向法律体系中已经引入的原则引入新原则，而是通过保护患者的最大利益并保护患者，其人格和尊严为其做出了重要贡献，有助于有益和一定程度地实施医疗保健自我决定是关怀与信任关系的中心。法律承认患者选择治疗的自由，包括拒绝或放弃医疗保健，并且通过定义医疗行动的界限，提高了对这种行动后果的确定性。

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