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燕赵晚报:是否“剖腹产”孕妇有根本决定权

2017-09-06 09:17:30   中国青年网

8月31日晚,陕西榆林市第一医院绥德院区住院部5楼,一名待产孕妇从楼上坠下身亡。医院发表声明称,“产妇生产期间,因疼痛烦躁不安,多次强行离开待产室,向家属要求剖宫产,主管医生、助产士、科主任也向家属提出剖宫产建议,均被家属拒绝。最终产妇因难忍疼痛,导致情绪失控跳楼。”并称,产妇跳楼身亡的根本原因与该院诊疗行为无关。而对此,产妇的丈夫并不认可,表示曾“主动跟医生说,她疼的话咱们就剖腹产”,“做剖腹产,我们不会不同意。”(9月5日《华商报》)

孕妇跳楼身亡的真相到底是什么?目前医院与孕妇家属双方仍是“各执一词”。笔者认为,无论最终事实真相是什么,相关医院事实上难辞其咎,根本不可能“与医院诊疗行为无关”。

因为即便医院声明属实,孕妇之所以没有及时实施剖宫产手术,是家属“拒绝剖宫产”所致,相关医院同样存在明显过失。因为在孕妇多次主动“要求剖宫产”的情况下,医院仍以“家属拒绝”为由,没有及时实施剖宫产手术,不符合相关医疗规范。依据《医疗机构管理条例》第33条,“ 医疗机构施行手术……必须征得患者同意,并应当取得其家属或者关系人同意并签字;《侵权责任法》56条也指出,“因抢救生命垂危的患者等紧急情况,不能取得患者或者其近亲属意见的,经医疗机构负责人批准,可以立即实施相应的医疗措施。”

这意味着,在抢救病人、实施剖宫产等手术过程中,“病人同意”才是一个最主要和核心的医疗程序,而“家属是否同意”只是一个相对次要的程序,也即在“是否动手术”问题上,患者的决定权高于家属。即使不考虑医疗规范,仅从“救死扶伤”等最基本的医疗伦理角度来看,以“家属拒绝”作为医院没有及时实施剖宫产的理由,坐视患者痛苦而不顾,最终导致患者跳楼自杀、酿成“一尸两命”悲剧,无论从医疗规范,还是医学伦理来看,医院都负有不可推卸的责任,绝不是一句“与医院诊疗行为无关”就能撇清的。

10年前的2007年,同样因为“丈夫肖志军拒绝在手术同意书上签字”而引发的“孕妇李丽云不幸死亡”事件,曾广受舆论关注;10年后的今天,类似的“家属拒绝剖宫产”而导致的孕妇死亡悲剧再度上演(如果“家属拒绝”确实属实的话),我们再次“踏进同一条河流”。如果不能充分厘清并严肃追究这背后的责任,此类孕妇悲剧,恐怕不会是最后一起。

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