尊重病人自主為臨床醫學倫理首要原則。病人面臨醫療選擇時，知情同意的過程，乃專業人員尊
重病人自主的具體作為。當專業人員與病人一同討論相關訊息，病人參與醫療討論的意願，受到
相當多因素的影響。本文從醫病互動、家人參與醫療決策以及病人特質三個方向，討論影響病人
參與醫療決策的因素。由於病人參與醫療決策受多重因素之影響，臨床專業人員協助病人做醫療
決策時，需留意社會文化脈絡下影響病人參與醫療決策的可能因素，始能引導病人表達個人醫療
意見，落實病人自主的倫理原則。

“Respect for autonomy”, the primary principle of bioethics, is the basis of the process of informed consent. It is the responsibility of medical professionals to provide information when patients are involved in medical situations and decision making. However, many factors can potentially interfere with patient willingness to participate in decision making processes. This article organizes and dis-cusses present knowledge on such factors. A thorough literature review was conducted to identify factors in terms of three aspects: interaction between health professionals and patients, family involve-ment, and patient characteristics. Patient involvement in medical decision making is a very complex issue. During the medical decision making process, health professionals must be aware of the social-cultural context of patients in order to create an environment in which patients feel comfortable to make decisions freely.