患者隐私权的民法保护——兼评《侵权责任法》第六十二条

<侵权责任法>将隐私权作为人格权加以确认,而第六十二条却仅规定医疗机构及其医务人员对患者个人隐私信息的保密义务,对于患者隐私权的保护略显不足.对患者隐私权的保护还包括,医疗机构及其医务人员未经患者同意不得侵入、窥视患者的私人领域.医疗活动通常不涉及患者私人活动的保护,精神科治疗是一个例外,医疗机构及其医务人员不得对精神障碍者与诊疗疾病无关的个人活动加以干涉、监视.     

婚检医疗纠纷的法律问题探讨

发生在婚前医学检查过程中的医疗纠纷增加了人们对婚前医学检查的负面评价和不信任.通过对近年来发生的婚检医疗纠纷进行研究发现,婚检医疗纠纷主要包括漏诊医疗纠纷、误诊医疗纠纷、侵犯隐私权和知情权医疗纠纷以及人身损害医疗纠纷四类.就婚检医疗纠纷所涉及的漏诊误诊责任的判断、损害后果范围的确定和医疗机构在知情权与隐私权冲突时的选择等相关法律问题进行了探讨,提出应当通过立法明确婚检疾病的范围和规范婚检医师的资质、婚检医疗机构严格保护受检者隐私和身体来防范婚检医疗纠纷的发生.     

湖北省保健干部健康状况主要影响因素分析

临床见习对整个医院医学体系维持、运行和发挥功能起着很重要的作用,但在具体实践中与患者的隐私权发生冲突时,又该如何保护患者的隐私权?以案件为例进行伦理分析,并通过伦理论辩求证"尊重自主原则"是保护患者隐私权的主要原则。     

从尊重自主原则谈患者隐私权的保护

临床见习对整个医院医学体系维持、运行和发挥功能起着很重要的作用,但在具体实践中与患者的隐私权发生冲突时,又该如何保护患者的隐私权?以案件为例进行伦理分析,并通过伦理论辩求证"尊重自主原则"是保护患者隐私权的主要原则.     

患者隐私权法律保护研究述评

患者的隐私权益能够体现患者人格尊严和价值,对于医学研究、公共健康保护具有积极意义。现有的关于患者隐私权法律保护相关研究包括:隐私权定义、患者隐私类型、患者隐私权保护机制、患者隐私权保护的限制及利益协调机制、患者隐私权易被侵犯原因分析、患者隐私保护需求顺位和患者隐私侵权构成要件等研究。关于患者隐私权的研究因为法律文化、立法传统等多种原因的不同而各异,目前的研究还没有达成共识;缺乏系统化、理论化的研究;有些研究还有待深入。     

对医疗纠纷问题的探讨——62例医疗纠纷临床分析

通过62例医疗纠纷的分析,证明医生的诊断和治疗是引发医疗纠纷的重要原因。经营医院的观念,对医疗纠纷的产生起到了一定的催化作用。为此,医疗纠纷的防范不仅要加强和完善制度的落实,更要加强医护人员的业务学习,提高医护人员的敬业精神,使之与社会的发展、人民的需求相适应,更要处理好政府、医院、患者之间的关系。     

对医疗纠纷问题的探讨--62例医疗纠纷临床分析

通过62例医疗纠纷的分析,证明医生的诊断和治疗是引发医疗纠纷的重要原因.经营医院的观念,对医疗纠纷的产生起到了一定的催化作用.为此,医疗纠纷的防范不仅要加强和完善制度的落实,更要加强医护人员的业务学习,提高医护人员的敬业精神,使之与社会的发展、人民的需求相适应,更要处理好政府、医院、患者之间的关系.     

论医师说明义务的法律性质

厘清医师说明义务的内涵、性质能够使患者和医师明晰自己的权利和义务,有利于保护患者知情同意权.对于医师说明义务的法律性质,有主张医师的说明系患者有效同意之逻辑前提的“承诺无效说”;也有“医疗合同上的附随义务”的观点;还有认为其应是一项法定的注意义务.在对这些观点进行评析后提出此义务应是一项法定的合同义务.     

患者隐私权的研究现状与保护进展

患者隐私权是患者的一项重要人格权。世界范围内病人权利运动的广泛开展及公民个人隐私保护意识的逐渐增强,使患者隐私权越来越受到关注。目前学者们对患者的隐私和隐私权看法各异,现行法律也没有统一明确的界定。但国内外对患者隐私权的研究与保护都有不同程度的关注与进展,并在法律上予以体现。     

患者隐私杈的法学思考

结合法学理论、医疗实践和目前患者隐私权的法律保护现状,就侵权行为、民事责任的认定以及隐私权的限制等问题予以理论阐释,并提出了切实可行的保护措施,如建立健全相关法律法规、医务人员要增强法律保护意识等,以期为患者隐私权的保护提供有益的参考。     

Legal and ethical issues in neuroimaging research: human subjects protection,medical privacy,and the public communication of research results

Humans subjects research entails significant legal and ethical obligations. Neuroimaging researchers must be familiar with the requirements of human subjects protection, including evolving standards for the protection of privacy and the disclosure of risk in "non-therapeutic" research. Techniques for creating veridical surface renderings from volumetric anatomical imaging data raise new privacy concerns, particularly under the federal medical privacy regulation. Additionally, neuroimaging researchers must consider their obligation to communicate research results responsibly. The emerging field of neuroethics should strive to raise awareness of these issues and to involve neuroimaging researchers in the legal, ethical, and policy debates that currently surround human subjects research.     

Trust in managed care organizations

Two basic criticisms of managed care are that it erodes patient trust in physicians and subjects physicians to incentives and pressures that compromise the physician's fiduciary obligation to the patient. In this article, I first distinguish between status trust and merit trust, and then argue (1) that the value of status trust in physicians is probably over-rated and certainly underdocumented; (2) that erosion of status trust may not be detrimental if accompanied by an increase in well-founded merit trust; and (3) that under conditions of managed care the physician's commitment to traditional medical ethics cannot serve as an adequate basis for merit trust. Next, drawing on an analogy between managed care organzations and politics, I argue that (4) the most appropriate basis for merit trust in managed care is a conception of organizational legitimacy that includes procedural justice, empowerment of constructive criticism within the organization, and organizational accommodation of the noninstrumental commitment to patient well-being that is distinctive of medical professionalism. I then explore the conditions necessary for robust competition for merit trust among managed care organizations and indicate the kinds of public policies needed to facilitate such competition. Finally, I show how the account of organization-based merit trust can accommodate the special fiduciary obligation of medical professionals, without indulging in the delusion that it is the physician's fiduciary obligation always to provide all care that is expected to be of any net benefit to the patient.     

医疗纠纷产生的法律根源及对策

当前,我国的医疗纠纷案件逐年增多。卫生立法滞后、违法现象严重、执法不统一、患者法律意识增强、鉴定程序不合理是产生医疗纠纷的重要法律根源。提出的对策：（１） 加快卫生立法,创建良好的法制环境;（２） 完善处理医疗纠纷的法律;（３） 严格执法;（４） 开展法制宣传工作,提高医患双方的法制观念。     

医疗纠纷产生的原因与防范

医疗卫生工作关系到人民的生命与健康,当患者的生命权或健康权受侵害时,就会发生医疗纠纷。医疗纠纷的产生既有源性因素,也有非医源性因素,提高医务人员的法律素养,强化医疗纠纷的管理,合理利用纠纷处理的补偿手段是防范医疗纠纷的有效途径。     

Routine third party disclosure of HIV results to identifiable sexual partners in Sub-Saharan Africa

The challenges of dealing with disclosure of HIV status cause frustration to health care providers and counselors. This frustration follows from the already known high risk to the third party on one hand and our ethical obligation to “respect persons” in terms of privacy and confidentiality on the other side. Given the stubbornly low rates of voluntary disclosure (partner notification) among couples, however, it is quite tempting to suggest a paradigm of routine third party disclosure to identifiable sexual partners by health care providers. This might be the lesser of the two evils and might give better public health outcomes in the fight against HIV/AIDS in Sub-Saharan Africa.     

WHY “DO NO HARM”?

Edmund Pellegrino has argued that the dramatic changes in American health care call for critical reflection on the traditional norms governing the therapeutic relationship. This paper offers such reflection on the obligation to “do no harm.” Drawing on work by Beauchamp and Childress and Pellegrino and Thomasma, I argue that the libertarian model of medical ethics offered by Engelhardt cannot adequately sustain an obligation to “do no harm.” Because the obligation to “do no harm” is not based simply on a negative duty of nonmaleficence but also on a positive duty of beneficence, I argue that it is best understood to derive from the fiduciary nature of the healing relationship.     

L'insertion du dossier psychologique dans le dossier médical,quelques réflexions sur un couple imparfait

The 2002 March the 4th law had reinforced the legal obligation of informing the patient about the elements of his medical file. Consequently, the topic of the medical file content came back keenly in debate and questioned the inclusion or the exclusion of the psychological notes and reports. The analysis reveals that, to date, there is no specific solution to this issue. So, even if it seems that, as a rule, the psychological report remains on the verge of the medical file, it might exceptionally become an integral part of it. From this point of view, this topic elicits the yet unresolved question of the psychologist status opposite the medical chief of staff.     

论当前医疗纠纷的表现特点,处理及防范对策

报道本教研室４３年３１６例医疗纠纷尸检资料的分析结果,结合实际工作经验与体会,论述当前医疗纠绿的表现特点,处理对策和防范措施。认为近年来医疗纠纷逐渐增多;发生科室以妇产科和外科多见;医疗纠纷中非医疗事故多于医疗事故。处理对策建议是：遵循法律,注意程序,讲究方法,公平合理。指出完善医疗管理是防范医疗纠纷的关键,提高医疗水平是防范医疗纠纷的根本。     

Understanding physician power: a review of The Social Transformation of American Medicine

Paul Starr's 1983 book on how physicians emerged with the power and authority to shape American health care institutions is reviewed. Daniels contends that Starr's analysis has important philosophical implications because it demonstrates that the medical profession, perhaps blinded by its own ethic, egregiously violated the common obligation of all citizens to promote justice in the design of institutions.     

Where should we draw the line between quality of care and other ethical concerns related to medical registries and biobanks?

Together with large biobanks of human samples, medical registries with aggregated data from many clinical centers are vital parts of an infrastructure for maintaining high standards of quality with regard to medical diagnosis and treatment. The rapid development in personalized medicine and pharmaco-genomics only underscores the future need for these infrastructures. However, registries and biobanks have been criticized as constituting great risks to individual privacy. In this article, I suggest that quality with regard to diagnosis and treatment is an inherent, morally normative requirement of health care, and argue that quality concerns in this sense may be balanced with privacy concerns.