An Ethical Study On The Issues Of Informed Consent Appeared In The Clinical Intervention Course Of Schizophrenia

The principle of informed consent, as an ethical guideline the treatment of diseases or medical experiments complied with, obtains moral defence for its protection of the moral rights of those patients with schizophrenia whose abilities to consent is in impairment status, but there are still a series of ethical problems demanding prompt solution during the clinical implementation process.The theoretical analysis and survey results show that the principle of informed consent obtains moral defense in clinical practice. First, the principle of informed consent has double ethical purposes which is to protect the moral rights and life value of patients with schizophrenia. As to the moral rights of patients with schizophrenia, the purpose of inform is to respect dignity of patients with schizophrenia, and the purpose of consent is to respect the freedom of will of patients with schizophrenia. Second, agent consent is a kind of extension of informed consent rights, and the institutional ethics connotated by agent consent has been recognized by legal system home and abroad. Third, between the the assessing models of consent abilities of patient with schizophrenia, based on the theory of utilitarian and moral commitment, the experience assessing is supported by substantive justice, and based on the theory of communication procedures and deontology, the tool assessing model is supported by procedural justice.The theoretical analysis and survey results show that some ethical issues are faced by the principle of informed consent during the clinical practice. First, the phenomena of generalization of the principle of informed consent is serious in clinical intervention process because of the severe confliction between the dual purposes of it. the principle of informed consent has not only failed to protect patients' life health and moral rights, on the contrary, it becomes the reason of declining diseases treatment of patients, and the doctors and patients are falling into a moral condemnation of the predicament in the same time. Second, during the process of proxy consent, moral risks, such as patient "was braved", the values of patient have been completely ignored, and a new kind of paternalism is taken shape and so on, appear because of the "fragile rights" of patients neglected, the power centralizination formed in the process of presumed consent and the proxy consent mis-interpreted. Third, the patient's informed consent rights are not protected substantively in clinical physician-patient interactions because the testability of the results of experience assessment based on substantive justice is not formidable, the behavior of experience assessment is with arbitrary, and the universality of tool assessment is not distinctness and so on. Fourth, it is lack of effective analysis whether there is correlation between the social factors and the extent to patients with schizophrenia of the understanding and appriciating of implication of the informed consent, which affects ethical care to vulnerable populations in patients with schizophrenia directly.Based on the theoretical analysis and empirical investigation, in order to address the above ethical issues, This study argues that the following measures should be taken. First, it is very important to avoid the generalization of informed consent effectively that the weak groups of informed consent in patients with schizophrenia shoud be determined, the cultivatiation of consent capacity of patients with schizophrenia shoud be strengthened, and the discourse power of psychiatrists in the process of schizophrenia intervention shoud be improved. Scend, the vulnerability rights and moral values of patients with schizophrenia should be respected in order to prevent moral risk, and the model of tool assessment should be promoted vigorously. Third, the consent capicity of patients with schizophrenia shoud be stratified in order to fulfil the ethical care to vulnerable group.In general, although the issuses that how to cultivate the consent capicity of patients with schizophrenia and how to promote model of tool assessment have yet to be studied furtherly, from the perspective of ethics and based on clinical empirical investigation, analyzing those matters of informed consent in the schizophrenia clinical intervention, putting forward a relatively feasible ethical response, this study has a strong theoretical and practical significance for the solution to the current ethical problems existing in such area.