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回归尊重 凝聚“产房里的共识”

2017-09-07 05:16:50   中国青年网

不仅是尊重产妇在面临分娩痛苦时的自我选择,更应该是对“人是目的而不是手段”这一人本精神的回归

近日,陕西榆林的一位产妇,在分娩时无法忍受疼痛并多次提出剖宫产未果的情况下,选择跳楼结束了自己的生命。这一悲剧,引发了人们对产妇、家属、医院三方角色的讨论。

围绕“谁拒绝了剖宫产要求”这一问题,医院与家属各执一词。截至目前,官方权威调查尚未公布,相关事实有待澄清。其实,类似事件已经不止一起。这让更多人思考,是什么导致了本不该发生的悲剧?如何才能避免悲剧重演?

在相关讨论中,人们在寻求真相的同时,也在探讨医疗规范问题。按《医疗机构管理条例》第三十三条规定,“医疗机构施行手术、特殊检查或者特殊治疗时,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;无法取得患者意见时,应当取得家属或者关系人同意并签字”。将“患者和家属的同意”作为医疗前置条件,这是对患者决策权和知情权的尊重,也是对医疗过程中医生临时处置权的限制,长远来看是对患者的保护机制。这种做法在很多国家都是惯例,但法律的规定往往在现实中遭遇考验。比如,责任权限的划分、经济效益的考量、落后观念的制约等。

因此,在讨论上述类似悲剧中,有人指出为了完成顺产指标医院具有倾向性,有人质疑具有专业判断的医生通过签字转移责任是否妥当,有人认为家属在婴儿成长和生二孩等现实考虑中会倾向顺产……这些因素在是不是剖宫产、要不要签字的问题上,增加了或多或少的犹豫。但对临产的孕妇来说,则让她们遭受了本不应该承受的痛苦,更为极端的情况是酿成了生命的悲剧。

由此看来,制度的完善和落实不仅需要医患双方在医疗行为中承担起应有的责任,更应该在价值观念中凝聚起更多“产房里的共识”。不论是舆论在这起事件中关注的“产妇多次要求剖宫产但没得到相关方积极回应”,由此引发的关于患者自决权的争论;还是在医学界热议的剖宫产临床指征,以及无痛分娩技术在中国发展的困境,这些讨论背后都折射出一个关键性问题,就是家属、医院乃至社会对产妇的真正尊重。这种尊重,不仅是尊重产妇在面临分娩痛苦时的自我选择,更应该是对“人是目的而不是手段”这一人本精神的回归。

应当看到,在科学技术快速发展的今天,有关医疗、法律的常识越来越普及,但一些更加重要的常识同样需要不断重申,比如对生命和个体的尊重,而后者恰恰是现代文明的基础常识。无论是医院还是家属,都需要更关注产妇的个人感受、更尊重她的自主选择。女性分娩是一件伟大的事,也是一件充满风险的事,不仅需要格外有力的技术手段和对风险的清醒预估,更需要对她们有着感同身受的理解与关怀,而不是止于制度,更不能只有利益。这样,或许才能避免悲剧发生。

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