Over the years ____1____ limit the hours of hospital interns and residents. Because someone putting in a 100-hour workweek might not be at their best when deciding which medication to prescribe or when inserting a Foley catheter. But doctors who have finished their training don’t face any restrictions in their hours. Now The New England Journal of Medicine argues in an editorial that sleep-deprived physicians set to perform elective surgery should have to ____2____ of the patient.
Sleep deprivation can ____3____ motor skills as much as alcohol intoxication can. The editorial cites a 2009 study in the Journal of the American Medical Association that found an increase in the risk for complications in patients who had elective surgery performed by surgeons who’d had the chance for less six hours of sleep during a previous on-call night.
The editorial's authors note that such consent represents ____4____. It could damage the patient-doctor relationship. But, they say, "This shift may be necessary until institutions take the responsibility for ensuring that patients rarely face such ____5____."
【视听版科学小组荣誉出品】
regulations have developed to get the informed consent impair a new responsibility for patients in making decisions about their care dilemmas
《新英格兰医学杂志》：昏昏欲睡的医生做手术需得到患者同意 多年来规章制度已经形成了限制医院实习生及住院医师的工作时间。因为有些医生在一周工作100个小时的情况下，当决定开出何种药物或何时插入尿管时就可能并不处于自己的最佳状态。可是，已经结束培训的医生在其工作时间里并未受到任何限制。现在，《新英格兰医学杂志》在一篇重要评论中指出，睡眠不足的医生在准备执行非紧急手术时应当得到病人的知情同意。 缺乏睡眠会损害人的肌肉运动技能，其程度同酒精中毒一样。这篇评论引用了《美国医学会杂志》上2009年发表的一项研究，该研究发现接受非紧急手术的患者，若其主刀医生之前值了夜班以致睡眠少于六小时，则该患者出现并发症的风险会增加。 该评论的作者指出，这种知情同意代表着病人在对其疾病做出决定时要承担新的责任。这或许会破坏医患之间的关系。但他们认为，“在制度体系能够保证病患几乎不会遇到这种困境之前，这种转变或许是必要的。”