急症产科子宫切除术知情同意的分析

为保留产妇的生命权而牺牲其生育权的子宫切除术,仍是控制产科出血的最后手段.产科急症时,患者本人无法做出意思表示,子宫切除术的知情同意权由其法定代理人行使.子宫切除围术期,实施知情同意,仍存在许多法律盲点及实践困难.本文阐述了产科子宫切除术告知的法律义务、行为主体,以及告知患者子宫切除的方式.     

国内外产科麻醉知情同意热点问题概述

知情同意是医患关系的基石。产科向来是医疗纠纷高发地,随着医疗模式的转变,舒适化医疗的推行,产科麻醉需求越来越多,有效保障产科麻醉患者知情同意,降低医疗纠纷发生率,具有重要的现实意义。本文首先阐述了产科麻醉知情同意的内涵,然后就产妇是否具有同意能力、医生告知义务标准和内容、产科麻醉知情同意的形式、母婴权利矛盾等国内外热点问题进行了论述,以期为国内产科麻醉知情同意研究及临床实践提供参考。     

是否告知重症患者病情的调查

本调查认为:目前多数人仍主张不将病情如实告知重症患者.我们应当清楚实情告知重症患者病情所面临的困难和患者知情同意权行使时的障碍,从而缩短社会承认医生告知的过程.     

医护人员对癌症告知态度的调查研究

为了了解医护人员对癌症告知的态度,对634名医护人员进行问卷调查.结果显示,医护人员不十分赞同将真情完全告知患者,其告知意愿在一定程度上取决于患者的知情愿望,他们比较认同家属拥有决策权,且普遍认为患者不是充分知晓病情.因此,医护人员应该增强告知认识,尊重患者告知意愿,引导家属告知观念,努力提高患者知情程度.     

医护人员对癌症告知态度的调查研究

为了了解医护人员对癌症告知的态度,对634名医护人员进行问卷调查。结果显示,医护人员不十分赞同将真情完全告知患者,其告知意愿在一定程度上取决于患者的知情愿望,他们比较认同家属拥有决策权,且普遍认为患者不是充分知晓病情。因此,医护人员应该增强告知认识,尊重患者告知意愿,引导家属告知观念,努力提高患者知情程度。     

术前谈话与患者的知情同意权

告知说明义务是医师的法定义务,知情同意权是患者的法定权利,术前谈话是外科医师履行告知说明义务和手术患者实现知情同意权的共同方式。外科医师应深入理解患者的知情同意权,合理履行告知说明义务,临床实践中做到告知说明内容充分,变更手术重新告知说明,避免使用穷尽式列举,确定签字人身份合法且具有完全民事行为能力。     

术前谈话与患者的知情同意权

告知说明义务是医师的法定义务,知情同意权是患者的法定权利,术前谈话是外科医师履行告知说明义务和手术患者实现知情同意权的共同方式.外科医师应深入理解患者的知情同意权,合理履行告知说明义务,临床实践中做到告知说明内容充分,变更手术重新告知说明,避免使用穷尽式列举,确定签字人身份合法且具有完全民事行为能力.     

中美医疗告知义务比较研究

《侵权责任法》第五十五条界定了医疗告知义务的内容和形式,以此保护患者知情同意权。然而,告知义务不仅限于该规定的内容,还包括转诊告知、治愈率告知等义务。在美国,医师与患者利益冲突也是告知义务的内容。对比中国大陆、台湾地区和美国的法律、案例,发现美国的医疗告知义务更侧重对患者知情同意权的保护,而中国大陆和台湾地区则侧重告知义务的履行形式。对告知义务的违反意味着对患者知情同意权的侵犯。在美国对侵犯知情同意权的责任形态区分故意和过失,而在中国大陆,通常不作区分,一般只认定为有过错。     

急症产科子宫切除36例临床分析

分析导致产科临床急症子宫切除的原因,探讨降低产科子宫切除的可能性方法.回顾分析我院产科2006年1月～2012年1月间36例急症子宫切除病例,胎盘因素占55.6％,子宫收缩乏力占27.8％,羊水栓塞占5.6％,子宫破裂占8.3％,晚期产后出血占2.8％.剖宫产术后行子宫切除31例,占剖宫产人数的0.39％;阴道分娩后5人行子宫切除,占阴道分娩总数的0.05％.为减少产后出血的发生,应严格掌握剖宫产指征,降低剖宫产率.     

《侵权责任法》视域中患者知情不同意的法律思考

患者知情同意原则本质地内涵着患者知情不同意的权利,医方对患者知情不同意更应谨慎处理.针对患者知情不同意的不同类型,在实践中适用《侵权责任法》时应当注意替代同意的效力问题,明确医方告知的信息范围和告知方式,并在患者拒绝治疗后谨慎处理医生干涉权和患者自主权之间的关系.     

基本人权保障与智障者节育手术开展可能性讨论——着眼“南通儿童福利院智障少女子宫切除事件”分析

分析国内外智障者节育手术多年实践提炼出共识:遵循法律规定开展此手术有利于保障而非侵害智障者基本人权。建议我国应出台相关规定为合法开展此类手术提供保障。     

L’affaire Lambert et ses enjeux constitutionnels

Despite a great number of legal analyses concerning the Vincent Lambert Case, only few of them adopt a constitutional point of view. This lack questions the relevance of Constitutional Law to protect rights and liberties. That is particularly true concerning the matter of the end of life. The right to life and the patient's right to consent (and refuse) to a medical treatment are not specifically enshrined by French constitution, (set aside the simple right to live freely). Therefore, this legal vagueness may lead to various interpretations of the fundamental law, which could promote rights and liberties as a tool protecting one's life, as well as it may recognize a real right to die.     

Death in Our Life

This paper examines a central aspect of the relations between duration and quality of life by considering the moral right to voluntary euthanasia, and some aspects of the moral case for a legal right to euthanasia. Would widespread acceptance of a right to voluntary euthanasia lead to widespread changes in attitudes to life and death? Many of its advocates deny that, seeing it as a narrow right enabling people to avoid ending their life in great pain or total dependence, or a vegetative state. I argue that the right cannot cogently be conceived as a narrow right, confined to very limited circumstances. It is based on the value of having the normative power to choose the time and manner of one's death. Its recognition will be accompanied by far reaching changes in culture and attitudes, and these changes will enrich people's life by enabling them to integrate their death as part of their lives.     

性别选择与法律之回应——法理视野中的变性手术

变性人的出现对社会秩序及法律制度提出了挑战。自然人生而具有的人作为社会主体定在的自由和健康权利,为变性人享有性别选择的权利提供了法理支撑。在权利确认后,很有必要在变性手术的对象、施行者及程序上作出规范的应对,而变性人术后的社会角色及权利保护也应该得到法律的适时回应,以实现法的秩序、公正等价值。     

医疗事故纠纷的本质及法律责任

医疗事故纠纷及处理的道德本质和司法原则在于对病人权利的维护。强化医务人员对病人生命与健康的医德责任感和病人权利意识,并使之成为自律、自觉的行为是预防和减少医疗事故纠纷发生的第一要素;而提高医务人员的法律意识,完善法律的制约机制,对医疗事故的防范是同样重要的。     

Right to life, right to die and assisted suicide

In 2002 Diane Pretty went to the European Court of Human Rights to gain a ruling about assisted suicide. In the course of this she argued that the right to life implied a right to die. This paper will consider, from an ethical rather than a legal point of view, how the right to life might imply (or not) a right to die, and whether this includes either a right that others shall help us die, or a right against non-interference if others are willing to help us. It does this by comparing the right to life to conceptions of property rights. This is not because I think human life is property, but because some of our ways of talking and thinking about our control over our own lives seem to be similar to our thoughts about our control over our own property. The right to life has traditionally been taken as a negative right, that is a right that others not deprive us of life. Pretty's argument, however, seems to be moving towards a positive right, not just to remain alive, but to be enabled in doing what we want to with our lives, and thus disposing of them if we so choose. The comparison with property rights suggests that the right to die only applies if our lives are ours absolutely, and may itself be modified by the suggestion that suicide harms all of us by devaluing human life in general.     

执业医师执业权利内容概论

执业权是执业医师享有的法定权利之一,但对执业权的具体内容尚缺乏较为系统的研究与认定.首次提出并论述执业权应该包括诊断权、治疗权、处方权、证明权、疾病调查与身体检查权、死亡确认权、终止治疗权等七项权利.     

The cultural moral right to a basic minimum of accessible health care

(1) The conception of a cultural moral right is useful in capturing the social-moral realities that underlie debate about universal health care. In asserting such rights, individuals make claims above and beyond their legal rights, but those claims are based on the society's existing commitments and moral culture. In the United States such a right to accessible basic health care is generated by various empirical social facts, primarily the conjunction of the legal requirement of access to emergency care with widely held principles about unfair free riding and just sharing of costs between well and ill. The right can get expressed in social policy through either single-payer or mandated insurance. (2) The same elements that generate this right provide modest assistance in determining its content, the structure and scope of a basic minimum of care. They justify limits on patient cost sharing, require comparative effectiveness, and make cost considerations relevant. They shed light on the status of expensive, marginally life extending, last-chance therapies, as well as life support for PVS patients. They are of less assistance in settling contentious debates about screening for breast and prostate cancer and treatments for infertility and erectile dysfunction, but even there they establish a useful framework for discussion. Scarcity of resources need not be a leading conceptual consideration in discerning a basic minimum. More important are the societal elements that generate the cultural moral right to a basic minimum.     

A Human Right to Internet Access: A Gewirthian Approach

The paper aims at exploring if we have sound philosophical reason to embrace a human right to Internet access. While attempts to make Internet access a candidate for the standing of human right have become popular in both the political and legal arenas, we still lack serious philosophical reflection on this issue. The paper first evaluates the arguments made by various authors, and then moves to provide its own conclusions. Its logic is that if (i) Internet access is crucial for enabling democracy, and (ii) democracy is a basic human right, then we may have at least prima facie reason to see such a technology as a derived human right whose normativity supervenes on the right to democracy.     

建设性后现代主义视域中的法律逻辑

随着以怀特海的过程思想、有机哲学为基础的建设性后现代主义思想对诸多学术领域的深度影响,在这种视域中研究法律逻辑似乎也具有了可能性。随着非形式逻辑、论证理论、法律方法以及司法实践等相关研究的发展,这种研究也具有了必要性。在建设性后现代主义视域中,法律逻辑应当是开放的、具体的、非中立和不确定的,这显然与现代性视域中的法律逻辑不完全一致。然而,前者并非对后者的逆反、对抗或颠覆,恰恰相反,前者的理论旨趣在于对后者的包容、摄入与超越。如果说后者追求的价值目标是真和善（正义）,那么,前者则在此基础上追求美与和谐。这种观点并非仅仅是人为的预制,更有其内在发展的逻辑。