????? ??????? (Informed Consent ) ???? ?????? ???????? ???????MPH ????? 83

1
??? ???? ?????? ??????
2
????? ???????(Informed Consent )???? ??????
???????????? ??????? ????? ? ????? ????? ???????
???? ????? ?????
3
??? ???? ? ????? ????? ??? ??? ?????
?? ??? ???? ??? ?? ????? ???? ????? ???? ?? ?????
.

• ?????? ???? ????? ??????? ????? ?????

4
??? ???? ? ????? ????? ??? ??? ?????
?? ??? ???? ??? ?? ????? ???? ????? ???? ?? ?????
.

• ?????? ???? ????? ??????? ????? ?????

???? ?????? ?? ???? ??? ??????? ?? ??? ? ???
????? ?????? ?? ????? ??? ??? ?? ??????? ?????
????? ???? ????? ?? ???? .
5
??? ???? ? ????? ????? ??? ??? ?????
?? ??? ???? ??? ?? ????? ???? ????? ???? ?? ?????
.

• ?????? ???? ????? ??????? ????? ?????

???? ?????? ?? ???? ??? ??????? ?? ??? ? ???
????? ?????? ?? ????? ??? ??? ?? ??????? ?????
????? ???? ????? ?? ???? .
??? ????? ???? ??????? ?? ?? ?? ???????? ??????
?? ?? ???? ?????? ???? ????? ???????? ????? ??? .
6
??? ???? ? ????? ????? ??? ??? ?????
?? ??? ???? ??? ?? ????? ???? ????? ???? ?? ?????
.

• ?????? ???? ????? ????? ????? ?????

???? ?????? ?? ???? ??? ??????? ?? ??? ? ???
????? ?????? ?? ????? ??? ??? ?? ??????? ?????
????? ???? ????? ?? ???? .
??? ????? ???? ????????? ?? ?? ???????? ??????
?? ?? ???? ?????? ???? ????? ???????? ????? ??? .
???? ??? ????? ?? ???? ????? ????? ?????? ????
??? ? ?? ??? ????? ??? ??? ??? ?? ????? ?? ?????
?????? ????? ?????? ???? ?? ????? ???.
7
??? ???? ? ????? ????? ??? ??? ?????
?? ??? ???? ??? ?? ????? ???? ????? ???? ?? ?????
.

• ?????? ???? ????? ????? ????? ?????

???? ?????? ?? ???? ??? ??????? ?? ??? ? ???
????? ?????? ?? ????? ??? ??? ?? ??????? ?????
????? ???? ????? ?? ???? .
??? ????? ???? ???????? ?? ?? ???????? ?????? ??
???? ?????? ???? ????? ???????? ????? ??? .
???? ??? ????? ?? ???? ????? ????? ?????? ????
??? ? ?? ??? ????? ??? ??? ??? ?? ????? ?? ?????
?????? ????? ?????? ???? ?? ????? ???.
...
8
??????? ????????? ???? ???????
?????????? ????????? ??????????
???????????????? ??????

• ?????

9
- ????? ?? AMA (1846-47) ???? ?? ??????? ??????
??????? ????? ???? ??????

• ???????

10
- ????? ?? AMA (1846-47) ???? ?? ??????? ??????
??????? ????? ???? ?????? - ??? ???? ????? ??
???? ???? ?? ???? ????? ?? ????? (Thomas
Percival)

• ???????

11
- ????? ?? AMA (1846-47) ???? ?? ??????? ??????
??????? ????? ???? ?????? - ??? ???? ????? ??
???? ???? ?? ???? ????? ?? ????? (Thomas
Percival)- ???? ????? ????? ??????? ?? ??? 1950
????? ?? ???? ????? ??? ?????

• ???????

12
- ????? ?? AMA (1846-47) ???? ?? ??????? ??????
??????? ????? ???? ?????? - ??? ???? ????? ??
???? ???? ?? ???? ????? ?? ????? (Thomas
Percival)- ???? ????? ????? ??????? ?? ??? 1950
????? ?? ???? ????? ??? ?????- ??? ????? ??
????? ?????? ?? ??? 1972 ?????? ?????? ???? ??
????? ????? ???? ? ???? ???

• ???????

13
- ????? ?? AMA (1846-47) ???? ?? ??????? ??????
??????? ????? ???? ?????? - ??? ???? ????? ??
???? ???? ?? ???? ????? ?? ????? (Thomas
Percival)- ???? ????? ????? ??????? ?? ??? 1950
????? ?? ???? ????? ??? ?????- ??? ????? ??
????? ?????? ?? ??? 1972 ?????? ?????? ???? ??
????? ????? ???? ????? ???- ??? ????? ??????? ??
????? ?? ?? ??????? ? ????? ???? ????? ?? ???
1981 ???? AMA

• ???????

14

• ?? ???? ???? ???? ?????
• ??? ??? ????? ????? ??????? ?? ????? ?? ???
  ????? ??????? ??? ??? ??? ?? ???? ????? ? ???? ?
  ????????? ???? ???? ????? ? ?????? ???? ?????
  ???.
• Ehtics in primary Care , Jeremy
  Sugarman , 2000 , Mc Grow-Hill , P 246

15
?????? ??????? ????? ?????? ????? ??? ????.
?????? ??????? ??? ?????? ?? ????? ???? ???? ????
.???? ???????? ??????? ?? ?? ????? ????
????.???? ???? ???.

• ??? ??? ??? ????

16
- Louis Harris and Associates Views of
informed consent and decisionmaking parallel
surveys of and the public, in Making Health Care
Decisions,President's Commission/or the Study of
Ethical Problems in Medicine and Bio- medical
and Behavioral Research. Washington, DC, U.S.
Government Printing Office, 1982.- Deber R,
Kraetschmer N, Irvine J What role do patients
wish to play in treatment decision making? Arch
Intern Med 1561414-1420, 1996. - Strull W, Lo
B, Charles G Do patients want to participate in
medical decision making? JAMA 2522990-2994,
1984.

• ??????? ?????

??????? ?? ?????? ?? ????? ????? ??? ???? ??? ?
?? ????? ??????? ?????? ????? ????.
17
- D, Hickham D Patients' preferences for risk
disclosure and role in decision making for
invasive medical procedures. J Gen Intern Med
12114-117, 1997.
??????? ?????
?? ?? ?????? ????? ???? ??????? ????? ?? ????? ??
?? ??? ????? ?? ????? ?????? ?????? ????? ?????.
18
- Louis Harris and Associates Views of informed
consent and decision making parallel surveys of
and the public, in Making Health Care Decisions,
President's Commission/or the Study of Ethical
Problems in Medicine and Bio-medical and
Behavioral Research. Washington, DC, U.S.
Government Printing Office, 1982.
??????? ?????
????? 96 ???? ????? ??? ????? ?? ???? ????? ??
??????? ????? ?? ????? ? ??? ???? ?? 50 ????
?????? ???? ???????? ??? ?????? ??? ???? ??
????????? ??? ?????? ?? ??????? ??? ????? ??
????? .
19
- Sulmasy DP, Lehmann LS, Levine DM, et al
Patient's perception of the quality of informed
consent for common medical procedures. J Clin
Ethics 5189-194, 1994.
??????? ?????
??????? ???? ?? ??? ???? ??????? ?????? ?? ?????
??????? ?????? ?? ??? ? ?? ?????? ??? ???? ??
???? ?????? ????????? ???? 53 ???? ??? .
20
- Louis Harris and Associates Views of informed
consent and decision making parallel surveys of
and the public, in Making Health Care Decisions,
President's Commission/or the Study of Ethical
Problems in Medicine and Bio-medical and
Behavioral Research. Washington, DC, U.S.
Government Printing Office, 1982.
??????? ?????
?? ????? ???? ???? ??? ??? ?? ????? ??? ????? ??
??? ???? ??????? ?????? ? ???? ?? 14 ???? ?????
?? ???? ????????? ??? ?????? ???? ??? ??? . ? ??
???? ????? ? ????? ?????? 9 ???? ? ??????? ??
????? ??? ? ??? ??????? ???? ?? 2 ???? ????? ????
????? ??? .
21
??????? ?????
????? ?????? ?????????!!! ?????? ???? ???? ????
??? ????? ??????? ????? ? ????? ?????? ????? ????
????? ????? ????? ? ????? ??? ????? ? ??? ? ?????
?????? ????? ? ????? ??? ?????????? ?? ?? ?????
?????? ??? . ??? ????? ???? ????? ????? ?? ????
?????? ? ????????? ?? ???? .
- Donovan J Patient decision making the missing
ingredient in compliance research. IntJ
Technol Assess Health Care 11443-55, 1995. -
Greenfield S. Kaplan S, Ware J Expanding
patient involvement in care effect on patient
out- comes. Ann Intern Med 102520-528,
1985. - Kaplan SH, Greenfield S, Ware J
Assessing the effects of physician-patient
interactions on the outcomes of chronic
disease. Med Care 27S110-S127, 1989. - Hulka B
Patient-clinician interactions and compliance.,
in Haynes R, Taylor D, Sackett D (eds)-Compliance
in Health Care. Baltimore, Johns Hopkins
University Press, 1979, pp 63-77. - Stewart MA.
Effective Physician Patient Communication and
health outcome a review CMAJ / 1995 , 152
1423-33
22
????? ??????? ??????? ?? ????? ??????? (? ?????
???? ) ??? ???? ?????? (?????) ???? ?? ?????? ??
????? ???? ?????? ( ?? ????????) ?????? ????? ??
????? ? ??? ? ??????? ?? ?? ?????? ?? ????? ???
?????? ?? ?????? ???????? ? ???????? ??? ?????? .
?????
Ehtics in primary Care , Jeremy Sugarman , 2000 ,
Mc Grow-Hill , P 247
23
?????
??????
???????
??????
?????
?????
??????
Ehtics in primary Care , Jeremy Sugarman , 2000 ,
Mc Grow-Hill , P 247
24
??? ) ????? ??? ? ????? ????? ????? ?? ????? ????
??????? ?????? ?? ??????? ???? ?? ??? ??
???? ????? ??????.????? ???????? ????? ??
?? ?? ???? ????? ????? ???? ???? . ????? ? ?????
??? ?? ????? ???? ?? ??? ??? .
????? ????? ?? ????? ???????
25
? ) ????? ????? ????? ? ????? ?????? ?? ????
????? ??? .??????? ???? ???? ????? ?? ????
??? ?? ??? ?? ????? ?? ???? ??????? ?????? ??????
??? .????? ???????? ??? ?????? ??? ?? ????
?? ?? ???? ????? ???? ???? . ???? ???? ????? ??
???? ?? ?? ???? ????? ???? ???? .
????? ????? ?? ????? ???????
26
? ) ????? ?? ???? ????? ??? ???????????
?????? ????? ???? ?? ???? ??? ????? ???? ???? ?
?????? ????? ????? ???? ?? ??? ????? ??
?????.????? ???????? ??? ?? ?????? ?????
???? ?? ???? ???? ?? ????? ???? ?? ????? ???? .
????? ????? ?? ????? ???????
27
? ) ????? ????? ? ???? ?????? ?? ???? ?? ?????
??? ???? ?? ???? ?? ??????? ????? ???????
?????? ???? ?? ???? ??? ???? ??? ??? ?? ????? ?
???? ??? ???? ????? ?? ???? ?? ??? ???? ????? ???
????? ?? ???? ??? ??? ?? ??? ??? ? ???? ??? ????
????? ?? ????? ??? .????? ???????? ????
????? ???? ???? ?? ??? ??? ?? ??? ??? ???? ?????
?? ?? ??????? ?? ???? . ???? ?????? ?????
????? ?? ?????? ????? ???? ?? ? ????? ?? ??? ???
?????????????? ????? ?? ?? ???? .
????? ????? ?? ????? ???????
28
????? ????? ?? ????? ???????
? ) ???? ???????? ??????? ???? ????? ?? ????
??? ??? ???? ??? ???? ? ??? ??????? ? ?????
?????? ????? ???? ???? ? ??? ??? .?????
???????? ???? ?????? ???? ??? . ???? ???????
?? ????? ??? ?? ??? ????? ????? ????? ??? ???
?? ??? .
29
? ) ??????? ? ??? ? ?????? ?????? ???????
???? ???? ?? ??? ????? ???? ??? ??????? ????? ???
?? ????? ??? ? ???? ?? ????? ?? ??? ??????? ???
??? ???? ??? ??? . ????? ????????
??????? ???? ???? . ????? ????? ?? ???
??? .
????? ????? ?? ????? ???????
30
??? ) ????? ????? ???? ??? ?? ???? ?????? ? ?????
?? ??? ???? ??? ??? ? ?) ????? ??? ??? ?? ?????
???? ?? ???? ????? ??? ??? ?
??????? ????? ??? ?????? ?????? ?? ????? ?? ??
??? ???? ????? ???
31
- Louis Harris and Associates Views of informed
consent and decision making parallel surveys of
and the public, in Making Health Care Decisions,
President's Commission/or the Study of Ethical
Problems in Medicine and Bio-medical and
Behavioral Research. Washington, DC, U.S.
Government Printing Office, 1982.
??????? ?????
?? ????? ???? ???? ??? ??? ?? ????? ??? ????? ??
??? ???? ??????? ?????? ? ???? ?? 14 ???? ?????
?? ???? ????????? ??? ?????? ???? ??? ??? . ? ??
???? ????? ? ????? ?????? 9 ???? ? ??????? ??
????? ??? ? ??? ??????? ???? ?? 2 ???? ????? ????
????? ??? .
32
????? ????? ?? ????? ???????
? ) ??? ????? ? ????? ????? ??????? ????
?????? ??? ?? ?? ??? ?? ????? ?? ????? ?? ????
?????? ?? ????? ???? ??? ?????? ?? ????? ?? ???
?? ?????? ???? ???? ??? ??? ????? ?????? ??? .???
??? ??? ??????? ?? ?? ????? ????? ?? ?? ????
?????? ??? ?? ?????? ?????? ???? . ?????
???????? ?? ??? ??? ??? ????? ??? .
?????? ???? .
33
???? ????? ??????
??? ) ????? ??? ? ????? ????? ????? ?? ????? ????
? ) ????? ????? ????? ? ????? ?????? ?? ???? ????? ???
? ) ????? ?? ???? ????? ??? ????
? ) ????? ????? ? ???? ?????? ?? ???? ?? ????? ??? ???? ?? ???? ?? ??????? ?????
? ) ???? ????????
? ) ??????? ? ??? ? ?????? ??????
? ) ??? ????? ? ????? ?????
34
?? ??? ???? ??? ????? ??????? ?? ?? ??? ???????
(Event Model) ?? ?? ??? ??????? (Process Model)
????? ?? ??? ?? ?? ?? ?? ??? ????? ?? ????? ???
?? ????? ????? ??????? ??? ??? ?? ?? ?? ?????
???? ?????? ?? ?? ??? ????? ???? ?? ?????? ? ??
???????? ?? ????? ? ?????? ????? ??? ?? ????
????? . ?? ??? ??? ????? ???? ???? ???? ????? ?
???? ???? ???? ???? .
167-174) Informed Concent , 2001 ,
Jessica W. Berg etc. ( P
35
??? ) ????? ??????? (Professional Practice) ?)
????? ??? ????? (Reasonable Person) (average of
Patient) ? ) ????? ????
SObjective?) Transparency
???? ?? ????? ??????? ???? ??? ?

36
???? ?? ?????? ???? ?? ????? ???? ????? ?????
??? ??? ?
37
?? ????? ??? ??? ???? ??? ????? ??????? ?????
???? ???? ???? ?????? ? ?????? ?? ???? ????? ?
???? ?? ??? ????? ???? ????? ? ?????? ????? ??? .
???? ?? ?????? ???? ?? ????? ???? ????? ?????
??? ??? ?
38
?????
??????
???????
??????
?????
?????
??????
Ehtics in primary Care , Jeremy Sugarman , 2000 ,
Mc Grow-Hill , P 247
39
??? ) ????? ????? ????? ????? ????

• ????? ????? ?? ????? ???????

40
??? ) ????? ????? ????? ????? ????
1- ????? ????? ??? ? ?????? ? ????? ?? ????
????? ???? ??? ? ?? ?????? ? ??? ????? ?? ???? ?
????? ?????? ???? ?? ????? ?????? ?? ????? ???? ?
... (????? ????? ???? ???? ?? ?? ??
????? ??? )

• ????? ????? ?? ????? ???????

41

• ????? (Force) ???? ????? ?? ??? ? ??????? ??
  ??????
• ????? (Coercion) ?????? ?????? ???? ? ????? ????
  ????? ????? ????? ?? ??? . ???? ??? ???? ?????
  ?????A ????? ?????? ? ???? ?? B ?? ???? ????? ??
  ??? ????? ?????? ??? ??? . ??? ????? ???? ??? ??
  ???? ?? ?????? ????? ?????? ??? .
• ???? (Manipulation) ????? ??????? ????

2- ????? ?????
Ehtics in primary Care , Jeremy Sugarman , 2000 ,
Mc Grow-Hill , P 250
42
?) ????? (??????) Capacity

• ????? ??????? ?????? ??????? ? ??? ? ??????
  ??????? ? ???? ? ????? ???? ? ?????? ???? ??????
  ??? ?? ??? ????? ????? ??? ?? ????? ????? ??? ???
  ????? ???? ?? ???? ??? .

Ehtics in primary Care , Jeremy Sugarman , 2000 ,
Mc Grow-Hill , P 247
43
?? ?????? ?? ??????? ????? 15?18???21 ??????.
????? ??? ??? ?????? ??? ?? ???? ?? ?? ??????
????? ??? .
????? ??? ?? ???? ??????
44
???? ???? ??????? ??? ???? ????? ????? ?? ?????
??? . ??????? ??? ?????? ? ???? ?? ???? ?? ??
???? ??? ??? ? ?? ???? ?? ?????? ??? ? ?? ???
????? ????? ???? ???? .
???? ????? ? ??????? ?????? ?? ?????
??????? ? 818???? ???? ??? ??? ???? ? ??
?????? ?? ?? ???? ??? ??? ?????? ??? .
???? ??????? ? ???? ???????
? ??????? ? ???? ?????? ? ? 1 )
45
??? ????? ?? ????? ?????? ?????? ?? ????? ????
???? ???? ???? ?? ???? ????? ????? ? ?? ????? ???
????? ???? ???? . ?? ???? ????? ???? ????? ????
?? ???? ??? ?????? ??? .
46
?? ?????? ?????? ???? ?? ??? ??? ??? ? ??? ???
???? ?? ????? ???? ??? ????? ?????? ???? ? ????
???? ?? ????? ??? ??????? ???? ???? ???? .
(???? ? ??????? ?????? ? ??? ??? ? 1383? ????
???? ???????? ? ??????? ? ???? 85)
47
?? ?? ?? ???? ???? ????? ???? ???? ?? ???? ?? ???
???? ??? ) ??????? ? ???????? ?????? ??????
????? ????? ?????? ????? .? ) ?????? ???????
????? ?? ????? ???? ?????? ????? ??? ????? ????
????? ?? ?????? ??? ? ????? ???? ?????? ??? ???
? ?????? ??? ???? ? ?????? ?? ??? ????? ???
.?) ???????? ????? ????? ?????? ?? ??????????
???? ?? ?? ??? ? ????? ? ???? ? ?????? ? ???????
??? ? ???? ??? .?? ?????? ???? ?????? ???? ?????
???? ???? ?? ?????? ? ??? ?????? ? ?????? ?
???????? ? ... ?????
(???? ? ??????? ?????? ? ??? ??? ? 1383? ????
???? ???????? ? ??????? ? ???? 86 ?85)
48
????? ????? ???? ???? ????
49
????? ????? ???? ???? ????

• ????? ??? ????? ??? ????? ???? ?? ????? ????
  ??? ??? ???? ???? ????? ??????? ? ?? ????? ????
  ??? . ??? ???? ????? ?????? ??? ???? ?????? ????
  ??? . ??? ???? ?????? ??? ?? ?????? ?? ?? ??? ???
  ?? ???? ?? ????? ???? ?? ????? ?? ????? ???? ?
  ???? ??? ???? ????? ??? .
• ?? ??????? ??? ?? ????? ?? ????? ??????? ??
  ???? ????? ???? ?????? ??? .
• ??????? ???? ???? ?? ???? ???? ???? ? ?????
  ???? ?????? ? 1373 ? ???????? ?????? ? ???? 189

50
?? ???? ????? ??? ???? ???? ????? ?? ???? ????
??? ??? ??? ?? ????? ??? ??? ???? ? ???? ?? ???
?????? ???? ?? ??? ???? ???? ??? ???? ??? ? ?? ??
?? ??? ???? ???? .
(?????? ?????? ??? 1363 ? ? 222)
51
???? ????? ? ??? ?????? - ???????? -
??? ???????? ???? ? ??????? ????? - ???? ???
???????
52
?? ??????? ????? ????? ?? ????? ????? ???
??????? ??????? ????? ??? ???? ?? ?? ????? ??
????. ????? ?? ????? ????? ??? ??? ????? ? ???
??? ?????? ????? ????? ??? ??? ?? ?? ????? ??
???? .
53
-????? ???? (??? ?? ? ????? ????? ?
...)-?????? ???? (???????? ????? ???? ?? ?
...)-????? ???? ( ?????? ??? ???? ?????? ? ???
??????? ???? ? ... )
(????? ???? ????? ?? ????? ? ?????? ??? ? ?????
???? ????? )
??? ?????? ???? ???
54
??? ?????? ?? ?? ????? ??? ????? ?? ??? . ?? ???
??? ?? ????? ?????? ?????? ?????? ?????? ??? ??
??????? ????? ?????? ???? .
55
?????
??????
???????
??????
?????
?????
??????
Ehtics in primary Care , Jeremy Sugarman , 2000 ,
Mc Grow-Hill , P 247
56
??????

• ??? ???? ????? ??????? ? ????? ? ? ?? ????? ???
  ?????? ???? ?? ?? ???? ? ?????? ????? Consent ??
  ????? ?????? ??????? Informed participation ??
  ??? Assent ?? ???? ?????? ??? ???? Passive
  Anthorization ???? ?? ??? ?????? ??? . (Assent
  ???? ??? ??? ???? ???? ).
• Ehtics in primary Care , Jeremy Sugarman , 2000 ,
  Mc Grow-Hill , P 241)

57
?????? ?? ????? ??????? ?? ???? ?? ?????? ??????
??? ?? ?? ??????? ? ????? ??????? ? ????? ?? ??
?? ?????? ????? ??? ?? ??????? ??? ????? ??
?????? ????? ?? ????? ???? ?????? ?? ?? ??? .
??? ???? ?????? ?????? ??????? ?? ??? ??? ??? ??
???? ???? ????? ?????? ????? ?? ?????? ??? ?????
?? ??? .
Ehtics in primary Care , Jeremy Sugarman , 2000 ,
Mc Grow-Hill , P242
58
?? ???? ????? ?? ????? ??????? ????? ?????? ??
????? ???? ?? ??? ????? ?? ??? .
??? ?????? ?? ????? ????? ?? ??? ?? ??? ? ??? ??
?? ?????? ??? ??????? ????? ? ?? ???? ????? ?????
????? .
59
??????? ??? ? ??? ?? ??? ?????
?????
????
???????
.......
???????
?????
60
?????
??????
???????
??????
?????
?????
??????
Ehtics in primary Care , Jeremy Sugarman , 2000 ,
Mc Grow-Hill , P 247
61
????????? ??? ????? ???????
62
????????? ??? ????? ???????

• ??????? ???? 59 ????? ?????? ?????? ?????
  ??? ??? ????? ??? ???
• ????? ??? ????? ?? ??? ????? ?? ?? ????? ??? ??
  ?????? ?? ???????? ?? ????????? ?????? ???? ?
  ????? ?????? ??? ? ???? ? ?????? ????? ????? ???
  ?? ????? ???? ??? ????? ????? ?????? ??? .
• ?? ?????? ?????? ????? ??? ????? ?? ??? ???? ???
  ?????? ?? ??? ?????? ?? ??? ?????? ??? ???? ??
  ??? .
• 
  Assent gt Consent

63
?????? ?????? Therapeutic Privillege??????? ??
??? ????? ??????? ?? ????? ?? ??? ???? ?? ????
??????? ???? ???? ?? ??? ??? ????? ?? ??? .
????????? ??? ????? ???????
(???? ? ??????? ?????? ? ??? ??? ? 1383? ????
???? ???????? ? ??????? ? ???? 24)
64
????????? ??? ????? ???????

• ?????? ( Waiver )
• ?????? ?? ??????? ?? ?????? ???? ??? ?????
  ?????? ?? ????? ???? .

- Kraetchmer N. Preference of Patience undergoing
Angiograms for participation in treatment
decisions Coping style and the Problem
Solving-decision making scale Masters Thesis
. Toronto University of Toronto , 1994 .
65
??? ??? ????? ????? ????? ???? ???? ?? ????? ???
???? ???? ??? ???? ??? ??? ?? ?? ?? ??? ????? ??
???? ??? ????? ????? ???? .
????
66
?????? ??????? ????? ??????? ????? ??? ????.
?????? ??????? ??? ?????? ?? ????? ???? ???? ????
.???? ???????? ??????? ?? ?? ????? ????
????.???? ???? ???.

• ??? ??? ??? ????

67
?????