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产妇“走了”,问题还在

2017-09-07 09:36:47   央广网

原标题:产妇“走了”,问题还在

新闻——据《新京报》9月6日报道,8月31日20时左右,陕西榆林市第一医院绥德院区住院部5楼,一名待产孕妇“因疼痛难忍导致情绪失控”跳楼身亡。院方表示,医护人员建议剖宫产,而家属坚持顺产,并多次拒绝产妇提出的剖宫产的要求;家属则表示,要求医院剖宫产被拒绝,“医生说马上就生了,不能剖宫产”。目前,榆林市卫计局已介入调查。

之一:手术必须家属签字?

1994年,国务院颁布的医疗机构管理条例规定,“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”。也就是说,除了患者自己同意外,还得有家属签字,医生才能进行手术,两个条件缺一不可。此番事件不管真相为何,家属是否签字都是关键。

不得不说,如此规定在某些情况下显得有些不合理。生命健康权是人的基本权利,对于一个意识清楚、有完全行为能力的人来说,其本该有权决定采取何种治疗手段。而且,家属和关系人的认知能力、判断能力及医学知识可能存在差别,很可能做出贻误治疗的决定。

2009年12月通过的侵权责任法中明确指出,“医务人员在诊疗活动中应当向患者说明病情和医疗措施。需要实施手术、特殊检查、特殊治疗的,医务人员应当及时向患者说明医疗风险、替代医疗方案等情况,并取得其书面同意;不宜向患者说明的,应当向患者的近亲属说明,并取得其书面同意。”根据该规定,一般情况下,患者同意就能实施手术;在患者昏迷等无法沟通的情况下,才需要征求家属意见。这种主次之分是比较合理的。而侵权责任法属于上位法,作为下位法的医疗机构管理条例应该在相关内容和精神上与上位法保持一致。

真相一定会调查清楚,但由此暴露出的患者手术签字权的问题,其实更应该引起重视。张淳艺

之二:规定应让位于生命?

有人认为医院是救死扶伤的地方,明明有孕妇急需治疗,医生却坚持家属必须签字同意,这是否过于教条?生命面前,规则能不能让路?

生命当然重要,但关键的医疗规则不能轻易打破。试想,如果“手术需经家属签字同意”这个规则可以打破,就意味着医生可以根据实际情况自行决定是否给患者做手术,那么拿什么来规范医院、医生滥用“手术决定权”?假如医生在家属没有签字的情况下实施手术,一旦出事,法律会因为医生的善心和主动施救而对其免于追责吗?家属维权之下,医生恐怕难逃违规操作之嫌。

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