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首页> 外文期刊>Journal of the American College of Radiology: JACR >Shared decision-making: is it time to obtain informed consent before radiologic examinations utilizing ionizing radiation? Legal and ethical implications.
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Shared decision-making: is it time to obtain informed consent before radiologic examinations utilizing ionizing radiation? Legal and ethical implications.

机译：共同的决策：在利用电离辐射进行放射检查之前，是时候获得知情同意了吗？法律和道德影响。

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摘要

Concerns about the possibility of developing cancer due to diagnostic imaging examinations utilizing ionizing radiation exposure are increasing. Research studies of survivors of atomic bomb explosions, nuclear reactor accidents, and other unanticipated exposures to similar radiation have led to varying conclusions regarding the stochastic effects of radiation exposure. That high doses of ionizing radiation cause cancer in humans is generally accepted, but the question of whether diagnostic levels of radiation cause cancer continues to be hotly debated. It cannot be denied that overexposure to ionizing radiation beyond a certain threshold, which has not been exactly determined, does generate cancer. This causes a dilemma: what should patients be informed about the possibility that a CT or similar examination might cause cancer later in life? At present, there is no consensus in the radiology community as to whether informed consent must be obtained from a patient before the patient undergoes a CT or similar examination. The author analyzes whether there is a legal duty mandating radiologists to obtain such informed consent but also, irrespective of the law, whether there an ethical duty that compels radiologists to inform patients of potential adverse effects of ionizing radiation. Over the past decade, there has been a noticeable shift from a benevolent, paternalistic approach to medical care to an autonomy-based, shared-decision-making approach, whereby patient and physician work as partners in determining what is medically best for the patient. Radiologists should discuss the benefits and hazards of imaging with their patients.
机译：由于利用电离辐射暴露进行诊断性影像检查而引起癌症的可能性越来越高。对原子弹爆炸，核反应堆事故以及其他未曾预料到的类似辐射的幸存者的研究已经得出有关辐射的随机效应的不同结论。高剂量的电离辐射会导致人类癌症，这一点已被普遍接受，但是辐射的诊断水平是否会导致癌症的问题仍在不断引起人们的争论。不能否认，过度暴露于电离辐射超过一定阈值（尚未确定）确实会导致癌症。这造成了一个两难境地：应该告知患者CT或类似检查可能在以后导致癌症的可能性吗？目前，放射线学界尚未就是否必须在接受CT或类似检查之前征得患者的知情同意达成共识。作者分析了是否有法律义务要求放射线医师获得这种知情同意，还分析了与法律无关的是否有道德义务迫使放射线医师告知患者电离辐射的潜在不利影响。在过去的十年中，从仁慈的家长式医疗方法到基于自主权的共享决策方法已经有了明显的转变，在这种情况下，患者和医师可以共同确定最适合患者的医学方法。放射科医生应与患者讨论影像学的好处和危害。

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