Provider Conscientious Refusal of Abortion,Obstetrical Emergencies,and Criminal Homicide Law

Catholic doctrine’s strict prohibition on abortion can lead clinicians or institutions to conscientiously refuse to provide abortion, although a legal duty to provide abortion would apply to anyone who refused. Conscientious refusals by clinicians to end a pregnancy can constitute murder or reckless homicide under American law if a woman dies as a result of such a refusal. Such refusals are not immunized from criminal liability by the constitutional right to the free exercise of religion or by statutes that confer immunity from criminal homicide prosecution. Core principles of the rule of law require the state to protect the lives of all persons equally and to place the life and health of persons above any the interests of providers have in moral integrity or in respecting the moral status of prenatal humans. In some states criminal liability related to conscientious objection also applies to corporate hospital officials.     

《医疗事故处理条例》中关于事故鉴定的几点思考

广受社会各界关注的《医疗事故处理条例》(以下简称《条例》)近日由国务院颁布 ,2 0 0 2年 9月 1日正式施行 ,1987年颁布的《医疗事故处理办法》(以下简称《办法》)同时废止。《条例》在医疗事故的概念及级别划分、医疗事故争议解决的途径、医疗事故技术鉴定、医疗事故赔偿以及违反该条例应承担的行政、民事、刑事责任等方面做出了较为详细的规定 ,较《办法》有了非常重大的突破。1　关于鉴定程序的启动在《办法》中规定 ,提请医疗事故技术鉴定的可以是患者及其家属 ,也可以是医疗机构 ,当双方对医疗事故或事件的确认和处理有争议时 ,可以提…     

医疗风险与医疗事故的辩证思考

2002年9月1日开始实施的新《医疗事故处理条例》,在医务工作者中引起了巨大的反响,依法行医和按照规章制度、医疗护理操作常规进行医疗活动的意识在医务工作者中普遍得到加强。但是,随着医疗风险引起的医疗纠纷越来越多,也使一些医务工作者在医疗活动中缩手缩脚,对风险大的治疗由于担心可能引起医疗纠纷而放弃,本应得到治疗的疾病因风险大而不能及时救治。因此,探讨医疗风险与医疗事故的内涵和关系,有利于医疗活动健康发展,真正做到救死扶伤,为伤病员服务。     

On a Belief-Relative Moral Right to Civil Disobedience

Res Publica - Acts of civil disobedience are undertaken in defense of a variety of causes ranging from banning GMO crops and prohibiting abortion to fighting inequality and saving the environment....     

医疗事故鉴定制度向何处去

《侵权责任法》实施后,在医疗损害民事纠纷领域,医疗事故鉴定制度失去了实体法基础,应当废除;在追究医疗行为行政及刑事责任领域,医疗事故鉴定有继续存在的必要,且应当对现行医疗事故鉴定制度进行重大改革,建议成立“医疗鉴定”专门机构,将“医疗鉴定”作为一个独立的司法鉴定类别,将医疗事故鉴定作为医疗鉴定的一个子项目;医疗事故鉴定专家应当由临床医学专家、法医与法律专家共同组成;鉴定结论由鉴定专家以个人名义做出,从而为追究违法医疗行为的行政责任和刑事责任提供科学依据.     

《医疗事故处理条例》的进步与争议

国务院 2 0 0 2年 4月 14日以第 35 1号国务院令的形式公布了《医疗事故处理条例》(以下简称《条例》) ,该法于 2 0 0 2年 9月 1日施行 ,其前身就是争议纷纷的《医疗事故处理办法》(以下简称《办法》)。这次修改不仅仅体现在名称上从办法变为条例 ,在内容上更是做了大幅度的修改、调整和完善。修改的内容主要体现在医疗事故的界定、患者知情权、医疗事故鉴定制度、医疗事故的赔偿制度等方面。1　医疗事故的界定医疗事故是医疗事故处理制度中的一个核心概念。因为 ,只有当某一医疗事件被鉴定为医疗事故时 ,医疗机构才承当赔偿责任 ;如果某一…     

从婚检看隐私权与知情权的冲突与协调

医生为当事人进行婚检,当发现其中一方患有性病等疾病时,告知是否会涉及到隐私权与知情权的问题,就隐私权与知情权的冲突与协调问题进行了探讨.     

中美医疗责任保险之比较研究

医疗责任保险是转移损害、分散风险的有效方法之一。为促进我国医疗责任保险的发展 ,对中美医疗责任保险的市场主体、产品供给、运营环境、运作实践和医界的保险意识进行比较分析 ,借鉴美国的先进经验 ,从社会系统工程的角度提出我国医疗责任发展对策     

Referral in the Wake of Conscientious Objection to Abortion

Currently, the preferred accommodation for conscientious objection to abortion in medicine is to allow the objector to refuse to accede to the patient's request so long as the objector refers the patient to a physician who performs abortions. The referral part of this arrangement is controversial, however. Pro‐life advocates claim that referrals make objectors complicit in the performance of acts that they, the objectors, find morally offensive. McLeod argues that the referral requirement is justifiable, although not in the way that people usually assume.     

完善我国医疗事故技术鉴定制度的思考

在我国,如何建立一个科学、完善、认同性高的医疗事故技术鉴定制度是社会各界十分关注的焦点.新<医疗事故处理条例>中关于医疗事故技术鉴定的相关规定较之旧<医疗事故处理办法>有了很大的进步.但随着实践的不断深入,发现现行鉴定制度存在医疗事故技术鉴定的组织者尚未真正的独立、鉴定组成人员实质没有改变、专家回避制度操作性差、集体鉴定制有悖法理的弊端,对此提出了相应的对策.     

精神科医师医疗干涉权的伦理限度

精神科医师特殊干涉权,因精神科领域医疗活动的行为、对象及医师权利具有特殊性,同时符合伦理学的不伤害原则和公正原则,这也是医师自主权的合理运用,因此具有合理性.但是在社会实践中,干涉权由于经常被扩张化而侵犯了患者的利益.由此提出干涉权必须坚持人道主义精神的、坚持医学伦理学的基本原则以及技术规范.     

Trauma-Informed Medical Care: Patient Response to a Primary Care Provider Communication Training

Trauma exposure predicts mental disorders and health outcomes; yet there is little training of primary care providers about trauma’s effects, and how to better interact with trauma survivors. This study adapted a theory-based approach to working with trauma survivors, Risking Connection, into a 6-hour CME course, Trauma-Informed Medical Care (TI-Med), to evaluate its feasibility and preliminary efficacy. We randomized four primary care sites to training or wait-list conditions; PCPs at wait-list sites were trained after reassessment. Primary care providers (PCPs) were Family Medicine residents (n = 17; 2 sites) or community physicians (n = 13; 2 sites). Outcomes reported here comprised a survey of 400 actual patients seen by the PCPs in the study. Patients, mostly minority, completed surveys before or after their provider received training. Patients rated PCPs significantly higher after training on a scale encompassing partnership issues. Breakdowns showed lower partnership scores for those with trauma or posttraumatic stress symptoms. Future studies will need to include more specific trauma-related outcomes. Nevertheless, this training is a promising initial approach to teaching trauma-informed communication skills to PCPs.     

20份医疗损害赔偿纠纷案件鉴定与判决书分析

以《侵权责任法》实施以来20份医疗损害赔偿纠纷案件二审判决书为基础,讨论鉴定与判决的关系.这些判决虽明示或默示采信鉴定报告,但判决结果与鉴定结论并不一一对应,显示出案件审理中司法判断力膨胀的特点.必须彻底抛 弃医疗事故鉴定体制、从严掌握多次鉴定申请,建立起合理的鉴定结论采信规则,增强判决的可预见性.     

Stress,Burnout, and the Special Services Provider

Burnout is a particular response to stress involving psychological withdrawal. It is a costly coping mechanism that can adversely affect the motivation, performance, and personal wellbeing of special service providers. The burnout response develops when more direct and active problem-solving efforts are perceived as useless. Research on the causes of burnout suggests that factors in the work environment are relatively more important than characteristics of individuals. Lack of clarity, control, support, and feedback, as well as work overload, are particularly significant sources of burnout in special education. Various strategies for preventing burnout have been developed, and some have been evaluated to a limited extent. They include individual strategies such as exercise, progressive relaxation, cognitive restructuring, and social problem-solving skills training. Group strategies such as social support groups and resource exchange networks, and organizational strategies such as participative decision-making structures, quality circles, and survey feedback for supervisors, also represent promising options.     

医疗联合体与就医的自我选择权

涉及民众自由、自我决定及对其的限制, 无疑是一项制度正当性的核心。自我决定权的价值不仅在于其处于人与人格的核心地位, 且从私法与公法、私权利与公权力的角度考量, 在可以避免国家代理的情况下, 必须设计权利直接行使的机制——自我决定权, 这既是权利本位法治理念的必然逻辑, 也是权利制衡和抗衡权力的重要方式。对权利的限制必须遵循必要性原则和适当性原则。我国不满足对民众的就医自我决定权限制的前提。