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产妇家属回应"小气拒手术":男方家有6孔窑洞 有车

2017-09-06 10:37:21   财新网

但在马茸茸死亡事件曝光后,其产前遭遇的疼痛和精神折磨,再次引起了医学界对无痛分娩的讨论。龚晓明即评论称,应积极推进无痛分娩,“都21世纪了,何必像原始时代一样强忍疼痛分娩”。

患者自决权

据财新记者了解,在此次榆林产妇马茸茸死亡事件发生前,2007年北京市也曾发生过一起与剖宫产手术决策纠纷有关的孕妇死亡事件。这两起事件都引起了法律界及公众对患者诊疗决策的广泛讨论。

2007年11月,孕妇李丽云因肺炎陷入危险,处于意识模糊状态,医生认为应该立马实施剖腹产手术。按《医疗机构管理条例》第33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”。

但李丽云的丈夫肖志军拒绝签字,坚持用药治疗,最后李丽云因严重的呼吸、心肺衰竭而不治身亡。事后李丽云父母认为医院对李丽云的死有不可推卸的责任,遂向法院提起诉讼。北京市第二中级人民法院判决称,朝阳医院已履行了医疗方面法律法规的要求,不构成侵权,但应补偿死者李丽云家属10万元。

与李丽云死亡案件相比,此次榆林孕妇之死的情况有所不同。从孕妇死亡所涉医院、家属的情况声明看,孕妇马茸茸生前曾明确要求实施剖宫产手术,对此上海市海上律师事务所律师刘晔分析称,孕妇既然有能力表达自己的意愿,“本人清醒的”,医院应给予尊重,而且医院如果也认为孕妇有必要做剖宫产手术,那为什么还要坚持让家属同意。

在2009年通过的《侵权责任法》中,第五十五条明确规定,“医务人员在诊疗过程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”;如果“不宜向患者说明”,应当向患者的近亲属说明,并取得其书面同意。

对此中国政法大学证据科学研究院教授刘鑫表示,分娩手术因为胎儿是父亲和母亲的,需要考虑家属的意见,但创伤是发生在母亲身上,因此如果患者和家属意见不一致,还是要尊重孕妇本人的意愿,“还是要听产妇的”,患者本人的决定权是受法律保障的。

但现实情况中,很多医院还没有树立尊重患者自主权的法律意识,即便医院有法律顾问,也没有很好地参与医院活动,只在医疗纠纷发生后才介入。刘鑫以榆林孕妇死亡事件为例进一步分析称,如果家属和孕妇出现了不同意见,就应当让医院法律顾问介入,让医务人员了解相关法律规定,这样便于医务人员作出判断,事后也能避免很多纠纷。

在刘鑫看来,很多医院会建议产妇,在产前把决定权委托给丈夫或其他亲属,但如果孕妇已经明确作出想要做剖宫产手术的意思表示,之前的“授权委托书就是无效的”,医院若因家属不同意而拒绝给孕妇做手术,其做法“从法律上肯定是有问题的”,违反法律对患者自主权的规定。

责任编辑:陈倩 CN030
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