自我概念の変遷とインフォームド・コンセント : 同意から合意へ(パネルディスカッション インフォームド・コンセントとは何か,<特集>病とは何か・癒しとは何か インフォームド・コンセントとは何か)

抄録

The notion of "informed consent" appeared recently as an ethico-medical term. But the concept is not new. Where people want to live peacefully with others consent has always been indispensable, and there could be no consent without information. Why is the term "informed consent" now the topic of discussion" ? This term suggests that modern medicine based natural science has lost humanism and regard recuperation. In spite of infestation of Paternalism, professional arrogance, pursuit of commercial benefit etc., not a few medical professionals live still in the illusion that the medicine were the representative system of humanism. There is another illusion that a patient could give consent as a free and independent individual. From the illusion comes the self-determination right of patient in his health care. If a individual were realy independent, is'nt "informed" consent self-contradictory? The informations given from doctors are often onesided and patients can be biased or even forced to give agreement. This kind of agreement can not be real and ethical consent. So long an individual were absolute independent there can be no consent but antagonism. Modern western philosophy established by Descartes stands on individualism or egoism. As an idea or a symbol of liberation of people from dictators, it had historical significance. But is any one realy absolutely independent and free? This question was already possible British empiricists. Hegle and Marx asserted that the free individual, thought to be a independent, self determining substance, cannot release himself from the contradiction of self-alienation. Husserl's Intersubjektiv and Watuji's Ningen (human relation in itself) suggest that a person can only be himself in a community of mutual dependence. This thought to one of the fundamental principles of Buddhism. The subject of the consent is not an individual, neither physician nor patient, but a community of physician-patient relation based on mutual trust and information. So the consent in this meaning or, in other word, accord is the principle of not only medical but universal ethics.