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不妨先来看看此前的案例。2007年发生的“丈夫拒签手术单致孕妻死亡”事件中,医生建议为产妇做剖宫产手术,但其丈夫拒绝在手术同意书上签字,最后导致孕妇死亡。医患双方因此打起了官司,最终法院判决医院无责。假如医院在其丈夫拒绝签字后仍实施手术,这起案件的判决结果会怎样?医院还能无责吗?
在我看来,类似事情更多的其实是医患沟通不足所致。当手术是唯一正确的选择时,如果患者家属仍不同意签字,可能是因为对情况认识不足、对手术及结果有不能承受的恐惧心理,毕竟在医生告知手术存在某些危险性和后果并要求签字负责时,没有几个家属能心静如水;也可能是另有隐情,比如无力支付费用、家庭成员之间存在矛盾,等等。假如医生与病患及家属沟通时能发现并排除某些不利因素、缓解家属的恐惧和焦虑,这种现象或可大幅减少。罗志华
他山之石
在欧美一些国家,当患者有决定能力时治疗方案仅由患者本人签字即可,当需要家属代为决定时患者本人须写书面委托书,而在面临危及患者生命的情况时,医生有责任实施救助,无须得到家属的同意,将拯救生命放在第一位。比如有的国家法律规定:“医生有权在病人面临生命威胁,或有导致身体残疾的危险时,在未得到病人同意以及未得到任何其他人准许的情况下,对病人实施救治。”
在危及患者生命安全的时刻,不应被“家属签字”的规定束缚住,而应将决定权交给医生,要信任医生的专业技术和医德,并给予相应的免责权。如果医生处理失误的话,则需要根据具体情况判断是否属于紧急救助时的必要措施,再决定应否承担责任和赔偿。
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