患者知情同意权—术前签字制度研究

发布时间：2018-11-13 18:45

【摘要】：目前,随着广大民众权利意识、法律意识的增强,医学技术的日新月异,导致患者对医疗效果的高期望值,加之我国不完善的医疗体制等综合因素作用下,医生与患者之间逐渐产生了隔阂,医患之间信任危机日益加重,医患关系日趋紧张。且二者矛盾正显现出愈演愈烈的趋势。同时医疗纠纷案件的数量近年也呈现上涨的态势,其中涉及知情同意权纠纷的案件亦有增加。并由此导致的医疗矛盾纠纷成为政府挂心、百姓关心的重大社会敏感问题。缓和紧张的医患关系,减少医疗纠纷构建和谐的医疗体系已成为亟待解决重大社会难题和民生问题。保障知情权的落实是缓解医患矛盾的重要手段之一。手术作为重要的医疗手段之一,对人身有较大损伤性,手术导致的医源性疾病或损伤屡屡发生,所以患者的知情同意至关重要,而一般情况下作为手术前置程序的术前签字在整个手术过程中起到告知患者、患者知情同意的作用。术前签字一方面是患者支配身体健康权的表现,另一方面是患者实施知情同意权的表现之一。所以当发生术前签字的例外情形时责任承担和保障患者知情同意权的实现显得十分必要。因此本文拟对患者知情同意权——手术前签字制度相关问题进行探讨。本文首先从知情同意权谈起,以案例的方式引入对知情同意权的讨论。作为术前签字制度的理论基础知情同意权,要明确知情同意权的法律属性,为下一步研究术前签字行为提供理论上的铺垫。其次笔者在讨论清楚知情同意权的法律属性后着重从术前签字的法律性质进行讨论,明确了术前签字制度的理论根源。同时又从实务的角度对术前签字的主体进行辨析,明确每一种签字主体的法理、伦理依据以及术前签字过程应注意的事项。笔者重点研究了诸如紧急情况下、强制医疗、患者放弃以及滥用权力等不需要患者同意即手术的情形以及各自的法律、法律根据以及在此情况下若出现手术风险时责任的承担问题。例外情形下权力规范的重要性显的异常重要所以在本文最后一部分提出了一些关于进一步规范签字制度的建议。本文笔者试图以文献研究法、结合四大案例进行研究以及系统研究的方法等方面进行着力探讨。希冀能为缓解医患矛盾,提高医疗质量,实现医生、患者利益共赢,促进医患关系和谐发展从而推动医事法律发展提出一些拙见。
[Abstract]:At present, with the increasing awareness of the rights of the general public, the enhancement of legal awareness and the rapid development of medical technology, the high expectations of patients for medical effects, coupled with the comprehensive factors such as the imperfect medical system in our country, are taking place. There is a gap between doctors and patients, the crisis of trust between doctors and patients is worsening day by day, and the relationship between doctors and patients is becoming more and more tense. And the two contradictions are showing a growing trend. At the same time, the number of medical disputes has also increased in recent years, including cases involving the right to informed consent dispute has also increased. And the resulting medical contradictions and disputes have become a major social sensitive issue concerned by the government and the common people. To ease the tense doctor-patient relationship and reduce medical disputes to build a harmonious medical system has become a major social problem and livelihood issues to be solved. The implementation of the right to know is one of the important means to alleviate the contradiction between doctors and patients. As one of the important medical methods, surgery has a large injury to the person, and the iatrogenic disease or injury caused by the operation occurs frequently, so the informed consent of the patient is very important. In general, as a pre-operative procedure, the pre-operation signature plays the role of informing the patient and the patient's informed consent during the whole operation. Preoperative signature is one of the manifestations of patient's right to exercise informed consent. Therefore, it is necessary to assume and protect the patient's right of informed consent when the exception of pre-operation signature occurs. Therefore, this paper intends to discuss the patient's right of informed consent-pre-operative signature system. This paper begins with the right of informed consent and introduces the discussion of the right of informed consent by way of case. As the theoretical basis of the pre-operative signature system, the right of informed consent should be clear about the legal attributes of the right of informed consent, and provide a theoretical basis for the further study of pre-operative signature. Secondly, after discussing the legal attribute of the right of informed consent, the author focuses on the legal nature of the pre-operative signature, and clarifies the theoretical origin of the pre-operative signature system. At the same time, the author distinguishes the subject of pre-operation signature from the angle of practice, and clarifies the legal principle, ethical basis and matters needing attention in the process of pre-operation signature. The author focuses on cases such as compulsory medical care, patient abandonment and abuse of power, which do not require patients' consent, and their respective laws. Legal basis and liability in the event of surgical risk in this case. In exceptional cases, the importance of power norms is very important, so in the last part of this paper, some suggestions are put forward to further regulate the signature system. In this paper, the author tries to discuss the methods of literature research, combined with four major cases and the methods of systematic research. It is hoped that it can alleviate the contradiction between doctors and patients, improve the quality of medical treatment, realize the win-win situation of doctors and patients, promote the harmonious development of doctor-patient relationship and promote the development of medical law.
【学位授予单位】：清华大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：D923

【相似文献】