FROM September 1, all surgical procedures will require a patient’s written consent, according to “The Standard for Writing Medical Records (for trial implementation)” recently declared by the Ministry of Health.

　Over the past few years, operations conducted with the consent of the patient’s relatives have frequently resulted in legal disputes. Some patients claimed they didn’t know certain organs were to be removed, or that the operation would cause serious side effects.

　The new regulations regarding written medical records have changed the previous practice where consent by the patient’s relatives was acceptable. It is stipulated that where consent is required for an operation, a special examination or special treatment, the patient’s signature is required so long as they are physically and mentally able.

　As a doctor, I strongly support the new standard for writing medical records, as I believe it is an important step forward in medical and health work.

　Previously, patients were often kept from knowing the truth of their conditions, and had no control over their lives and well-being.

　The previous practice was backward because it showed no respect for patients.Patients have the right to know everything about their conditions and operating procedures, and doctors must explain everything very clearly.

　Some may be concerned about negative psychological effects the new standard may have on some patients. But that is another thing to deal with.

　If some patients are not psychologically strong enough, they can turn to counselling.We can look at the advantages of the new practice from both sides. For patients, it shows full respect for their rights to know the truth and make decisions concerning their own lives. For doctors, it provides necessary proof whenever disputes arise.

　　The new regulations will supplement the insufficiency of the current law by following international customs and standardizing medical affairs.In the view of the law, the new standard has more clearly defined the rights and duties of both sides where doctors and patients sign a “contract” for an operation.It is beneficial for both parties when disputes arise. Disputes will be easier to settle under the new regulations.The disadvantage of the new standard is that it might have certain psychological effects on some patients. It will depend on a patient’s psychological attitude.However, I believe the advantages of the new regulations outweigh the disadvantages. The purpose of the new standard is to try to balance social relations and promote social stability.

　　I don’t support the new standard. I’m wondering if the new regulations can really protect the rights of a patient.I’d like to borrow a commonly used term, SOP (Standard Operation Procedure), from management science to clarify my point. SOP can help us better understand who should ultimately be responsible for an action and what is the purpose of the action. Suppose a patient signed an operation consent but the operation was not successful. Who would be responsible for the failure and who would pass judgement? Since the patient has signed the consent, would the doctor be exempt from a charge of negligence? In view of SOP, I believe doctors should always be responsible for their surgical procedures, no matter what happens.Doctors and patients are in unequal positions in the medical relationship. Patients are always in the weakest position. They have to trust the doctor’s expertise for their health and well-being.Past experience has taught me that when a patient is in dire peril, the signature, no matter whose it is, is not important. Only the doctors’ professional ethics and skills matter. The new standard lacks humane concerns for patients. It may well serve the purpose of protecting doctors’ rights but not those of the patients.