论自我决定权与紧急救治权的适用——关于《医疗机构管理条例》第三十三条的探讨
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摘要
为更好地规范我国医疗机构的管理,保障患者自我决定权与医疗机构紧急救治权的行使,基于《医疗机构管理条例》第三十三条的立法原意与具体适用的冲突,从患者自我决定权、上位法原则、紧急救治权、救死扶伤四个角度出发,分析法条存在的问题,提出法条应明确患者的自我决定权,家属的意见必须是对患者有利的,才可在患者无法做出决定时成为决定性因素;在无法取得患者意见且患者近亲属的意见明显不利于患者,但医务人员认为有立即手术的紧迫性时,可以对患者进行紧急救治。
In order to regulate the management of medical institutions and guarantee the self-determination right and right of emergency treatment, based on the conflicts between the original intention and the specific application of clause 33 in "Regulations on the Administration of Medical Institutions", this paper analyzes the problems from the four perspectives of patient self-determination, superior law principle, emergency treatment, and the medical ethics. The clause should clarify the patient's right to self-determination, and the family's consent must be beneficial to the patient before it can become a decisive factor when the patient is unable to make a decision; the patient's consent is not available and the patient's close relatives are obviously not conducive to the patient, while when the medical staff believes that there is an urgent need for immediate surgery, the patient can be treated urgently.
In order to regulate the management of medical institutions and guarantee the self-determination right and right of emergency treatment, based on the conflicts between the original intention and the specific application of clause 33 in "Regulations on the Administration of Medical Institutions", this paper analyzes the problems from the four perspectives of patient self-determination, superior law principle, emergency treatment, and the medical ethics. The clause should clarify the patient's right to self-determination, and the family's consent must be beneficial to the patient before it can become a decisive factor when the patient is unable to make a decision; the patient's consent is not available and the patient's close relatives are obviously not conducive to the patient, while when the medical staff believes that there is an urgent need for immediate surgery, the patient can be treated urgently.
引文
[1] 刘召成.民事权利的双重属性:人格权权利地位的法理证成[J].政治与法律,2016(3):106-115.
[2] 刘小红.我国医疗侵权知情同意原则问题研究:以借鉴美国法为视角[J].暨南学报:哲学社会科学版,2014,36(7):74-82.
[3] 曾见,葛晓敏.医生告知义务的类型与范围:来自德国的启示[J].医学与哲学,2017,38(9A):70-72.
[4] 邹雪.榆林产妇坠楼事件涉法问题分析[J].法制与社会,2017(33):58.
[5] 全国人大常委会法制工作委员会民法室.中华人民共和国侵权责任法解读[M].北京:中国法制出版社,2010:277.
[6] 徐雏.从安乐死事件看生命健康权与人格尊严权的权衡:以2005年美国特丽·夏沃案为例[J].法制与社会,2013(2):65-66.
[7] 李杰.患者知情同意制度的再解释:论《侵权责任法》第55条[J].法学杂志,2017(8):124-131.
[8] 吴健涵.论危急病症手术中紧急救治义务的履行:以《侵权责任法》第五十六条为视角[D].上海:华东政法大学,2016.
[9] 高雪娟.论医疗损害抗辩事由的应用[J].医学与哲学,2015,36(5A):5-8.
[2] 刘小红.我国医疗侵权知情同意原则问题研究:以借鉴美国法为视角[J].暨南学报:哲学社会科学版,2014,36(7):74-82.
[3] 曾见,葛晓敏.医生告知义务的类型与范围:来自德国的启示[J].医学与哲学,2017,38(9A):70-72.
[4] 邹雪.榆林产妇坠楼事件涉法问题分析[J].法制与社会,2017(33):58.
[5] 全国人大常委会法制工作委员会民法室.中华人民共和国侵权责任法解读[M].北京:中国法制出版社,2010:277.
[6] 徐雏.从安乐死事件看生命健康权与人格尊严权的权衡:以2005年美国特丽·夏沃案为例[J].法制与社会,2013(2):65-66.
[7] 李杰.患者知情同意制度的再解释:论《侵权责任法》第55条[J].法学杂志,2017(8):124-131.
[8] 吴健涵.论危急病症手术中紧急救治义务的履行:以《侵权责任法》第五十六条为视角[D].上海:华东政法大学,2016.
[9] 高雪娟.论医疗损害抗辩事由的应用[J].医学与哲学,2015,36(5A):5-8.