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唏嘘之外,更要反思

2017-09-06 06:26:54   中国青年网

8月31日晚,陕西榆林市第一医院绥德院区妇产科一名孕妇从5楼分娩中心坠下,抢救无效身亡。

一开始媒体报道,据医院方面说法,是因为家属不同意剖腹产令产妇无法忍受,故而选择了极端的方式。但家属很快回应,称当孕妇中间出来喊疼的时候,他们同意做剖腹产,但医生表示“检查后产妇一切正常,快要生了,不用剖腹产”。这给事件蒙上了一层迷团,仿佛就此陷入了罗生门。

虽说在官方结论出来前,不宜妄加猜测,但在我看来,真相并非那么扑朔迷离。医院妇产科现在大多鼓励顺产,而不再像以往动不动就给产妇剖腹产,但针对具体情况,医生并不会一味坚持顺产,而不让剖腹产。道理很简单,如果在分娩过程中可能危及产妇或胎儿安危,而明摆着剖腹产就可以化解危机,哪个医生愿意冒着各种风险坚持顺产?剖腹产本身并不是什么高难度手术,医院不建议只是为了防止手术被滥用,真的需要剖腹产,医生不太可能走极端。

再从产妇这边来看,分娩过程中的疼痛固然难以忍受,但让一个人产生绝望心理的,也不可能是来自于医院,而只能是自己的亲人。唯有对亲人的巨大失望,才会让人对生命绝望。尤其是,当她怀里还有一个生命,正常情况下,她又怎么可能轻易放弃?

更何况,如果产妇和家属都表示要剖腹产,而且知情同意书上也已写明胎儿“脐带异常”(这是多数产妇需要剖腹产的原因),这时候医院更加不可能一味坚持要顺产。知情同意书上分明还有家属的两次签名,均要求顺产,并“谅解意外”。这样看的话,答案其实已经很明显了。可以体谅家属的悲痛心理,但从目前的各种证据和迹象看,道理并不站在他们这边。

只不过,这事情单纯去判断谁是谁非意义不大,如何避免类似悲剧的发生,才是更重要的事情。究根结底,这起悲剧之所以发生,背后还是信任缺失的缘故。

首先是家属基于顺产迷信而不信任医院的专业意见,甚至不顾产妇的哀求,为悲剧埋下导火索;再者是产妇在分娩过程中,不仅对医院而且对家人也失去了信任,这才产生巨大的绝望心理;还有就是,医院基于对医患冲突的防范,以及为规避医疗责任,在各个环节均要求家属签字,这限制了医生尽可能发挥主观能动性,从而痛失挽救产妇的最后机会。

事实上,这其中只要有一个环节起到主导作用,悲剧都不会发生。如果家属不固执己见,而是选择尊重产妇情感或医院专业判断,那么产妇有亲人作为依赖,无论如何不会走极端,而医院也会针对产妇分娩过程中的情况变化积极应对。医院这边,如果能够不囿于家属签字,或者更主动地向家属介绍病症,给出更明确的专业意见,或许可以改变家属的态度,为专业治疗创造有利条件。

在这起悲剧里,我们选择相信谁的说法是一回事,但这背后所掩藏的酿成悲剧的各种成因,更值得反思。产妇选择以极端方式终结生命,让人唏嘘,而悲剧发生前各方的“不合作”,何尝不让人深感悲哀。从这角度来讲,这场悲剧并没有随着生命的逝去而终结,目前家属与医院的争端,不过是这场悲剧的延续。

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