《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.     

对急危重症患者家属签署知情同意书中不同意的病例回顾分析

分析在急危重症患者中签署知情不同意的原因,探讨对策.选择我院2010年6月1日～2011年12月30日在ICU抢救已出院归档的急危重症患者家属签署的600份知情同意书中52份不同意的病例进行分析总结.52份病例的知情同意书签字不同意,原因多方面.知情不同意是患者或家属的权力,如何保障更好行使此权利,同时保障其健康是医务人员努力的目标,也需要对出现的问题进一步探讨.     

“拔牙要签同意书案”的知情同意探究

让患者知情同意义务是近些年来在医疗诉讼过程中逐步从一般注意义务中分化出来的特殊注意义务。但如何确定患者知情同意,如何界定医生行使告知义务时的信息披露程度,一直没有一个确定的标准,在法律、医患沟通、医疗保险制度等方面还有许多要完善的地方。     

"拔牙要签同意书案"的知情同意探究

让患者知情同意义务是近些年来在医疗诉讼过程中逐步从一般注意义务中分化出来的特殊注意义务.但如何确定患者知情同意,如何界定医生行使告知义务时的信息披露程度,一直没有一个确定的标准,在法律、医患沟通、医疗保险制度等方面还有许多要完善的地方.     

乡村医生对知情同意与保密的认知态度调查分析

对河北省5个地区近800名乡村医生进行抽样调查显示,乡村医生对知情同意和保密的认知度较高。其中绝大多数医生能够在医疗实践中坚持知情同意和保密的伦理原则,但乡村地域文化和医疗服务的特点决定了乡村医生在履行知情同意时具有不同于城市的独特性。对乡村医生来说,应进一步明确知情同意中尊重患者选择权与乡村医生责任的关系,并通过有效沟通行使知情同意权及规范保密的具体内容,确保在医疗实践中更好地做到知情同意与保密。     

浅议侵害患者知情同意权的性质及赔偿

知情同意是患者自主权的重要体现,侵害患者知情同意权是引发医惠纠纷的常见原因。知情同意权是患者身体权、隐私权、财产权和支配权的集中体现,对患者知情同意权的侵害直接表现为对患者身体权、隐私权或财产权的侵害,医疗机构应该承担相应的精神损害赔偿、财产损害赔偿的责任。     

医事法学视野下患者同意能力的判断

同意能力是知情同意理论中的重要概念,是患者行使自主决定权的必备前提条件.在医事法学视野下展开研究,对目前理论和立法现状进行分析,把客观定型化的年龄界限与量化评定工具相结合,共同构成我国患者同意能力的判断标准.为该领域研究提供思路,进一步完善我国知情同意理论体系.     

急诊医疗中的知情同意问题

急诊医疗中的知情同意似乎与通常的临床情形不同,它不需要完全的知情同意,甚至可以被免除。这一特点可能给人以一种印象,即在急诊情况下对知情同意的考量,或可与其他情形有所不同。其实急诊情形下之所以出现知情同意的例外或免除,并非知情同意原则在急诊情况下不适用,或者是知情同意原则做出了让步。真正的原因是,知情同意在急诊治疗中往往以特殊或不同的形式表现出来。     

急诊医疗中的知情同意问题

急诊医疗中的知情同意似乎与通常的临床情形不同,它不需要完全的知情同意,甚至可以被免除.这一特点可能给人以一种印象,即在急诊情况下对知情同意的考量,或可与其他情形有所不同.其实急诊情形下之所以出现知情同意的例外或免除,并非知情同意原则在急诊情况下不适用,或者是知情同意原则做出了让步.真正的原因是,知情同意在急诊治挝疗中往往以特殊或不同的形式表现出来.     

尊重自主权:如何面对患者的知情不同意——全国10城市4000名住院患者问卷调查研究报告之五

如何面对患者的知情不同意,是医师尊重病人自主权时必须正确对待的问题,也是医师履行职业责任不可回避的事实.通过问卷调查及深入访谈,对目前我国病人及家属知情不同意的现状,知情不同意的类型、原因以及医师面对病人的知情不同意时容易走进的误区,正确处理知情不同意的意义做了分析和讨论,以便为维护患者的利益,减少医惠冲突,完善医师专业精神提供参考依据.     

SECRECY IN CONSEQUENTIALISM: A DEFENCE OF ESOTERIC MORALITY

Sidgwick's defence of esoteric morality has been heavily criticized, for example in Bernard Williams's condemnation of it as 'Government House utilitarianism.' It is also at odds with the idea of morality defended by Kant, Rawls, Bernard Gert, Brad Hooker, and T.M. Scanlon. Yet it does seem to be an implication of consequentialism that it is sometimes right to do in secret what it would not be right to do openly, or to advocate publicly. We defend Sidgwick on this issue, and show that accepting the possibility of esoteric morality makes it possible to explain why we should accept consequentialism, even while we may feel disapproval towards some of its implications.     

Knowing that, knowing how, and knowing to do

Ryle’s distinction between knowing that and knowing how has recently been challenged. The paper first briefly defends the distinction and then proceeds to address the question of classifying moral knowledge. Moral knowledge is special in that it is practical, that is, it is essentially a motive. Hence the way we understand moral knowledge crucially depends on the way we understand motivation. The Humean theory of motivation is wrong in saying that reason cannot be a motive, but right in saying that desire is essential for motivating us. The right response to the Humean theory of motivation is to see that moral knowledge is desire-related rationality or thought-related desire. Moral knowledge is neither knowing that nor knowing how but rather a third species of knowledge which we may call “knowing to do.” Knowing to do is to be rationally disposed to do the right thing. This understanding of moral knowledge is exactly what we can learn from Aristotle’s ethics.     

道德实践中的认知、意愿与性格——论程朱对“知而不行”的解释

知而不行是生活中常见的现象,比如,一个人知道吸烟不好,却依然吸烟;知道应该帮助他人,却没有付诸行动。儒学,尤其是宋明理学,作为一种强调道德修养和道德实践的学问,对道德领域的知而不行现象,给予了更多关注。从二程到朱熹到王阳明,都对这个问题做过正面回应,     

Sex differences in the effect of exercise upon sleep.

A survey in a high school in the city of Troms? in the spring of 1988 was designed to examine the characteristics of sleep and factors promoting and disturbing sleep. Out of 621 students 465 (74.9%) responded to 11 questions about last night's sleep and what the individual perceived as usual sleep (10 questions). On this information two sleep-quality scores, a special score for last night's sleep and a general score for what is perceived as usual sleep, were computed. The sleep-quality score was the sum of answers identical to a preset "right" answer indicating good sleep-quality. Multiple regression analyses separately by sex showed that different variables influence sleep-quality of boys and girls. Activity and intensity of exercise were taken into the regression model for the special sleep-score for boys but not for girls. For girls psychological factors seemed of greater importance to sleep-quality than exercise.     

A Value Pluralist Defense of Toleration

Philosophia - In situations where we ought to tolerate what we morally disapprove of we are faced with the following moral conflict: we ought to interfere with X, we ought to tolerate X, we can do...     

Coping With the Less Interesting Aspects of Training: Toward a Model of Interest and Motivation Enhancement in Individual Sports

Kendzierski and Sheffield (2000) found that exerciser schematics made less stable attributions for an exercise lapse than did aschematics; this could occur because they either perceived similar causes differently or encountered less stable obstacles to exercise. This research tested the perceptual explanation by examining the stability of the attributions that undergraduates who did versus did not have an exerciser self-schema made for specified lapses that they imagined as having happened to themselves versus another student. It also explored whether exerciser self-schema status was associated with differences in attributions of personal and external control. Consistent with the perceptual explanation, students with an exerciser self-schema made less stable attributions for a lapse imagined as having happened to themselves than did students without an exerciser self-schema, but equally stable attributions for a lapse imagined as having happened to another. Moreover, a content analysis revealed that the 2 groups cited similar causes for their own imagined lapses, providing further evidence that the difference in perceived stability was due to the groups perceiving similar causes differently. Exerciser self-schema status was not associated with attributions of either personal control or (in any clear way) external control.     

Suppressing where but not what: the effect of saccades on dorsal- and ventral-stream visual processing

Some cognitive processes are suppressed during saccadic eye movements, whereas others are not. In two experiments, we investigated the locus of this interference effect. In one experiment, subjects decided whether pictured items were objects or nonobjects while making saccades of different lengths. Saccade distance had no effect on response time, indicating that saccades do not interfere with object recognition. However, in a second experiment, in which subjects decided whether pictured items faced to the left or to the right, response time increased with saccade distance, indicating that processing was suppressed during the saccade. These results (along with others) suggest that dorsal-stream (where) processes are suppressed during saccades, whereas ventral-stream (what) processes are not. Because the dorsal stream is instrumental in generating saccades, we propose that cognitive saccadic suppression results from dual-task interference within this visual subsystem.     

How do people know?

To fully understand processes of knowing and knowledge acquisition, it is necessary to examine people's understanding of their own knowing. Individual and developmental differences in what it means to know something, and hence in the criteria for justifying knowledge claims, have potentially wide-ranging implications. In providing support for a claim, young children have difficulty differentiating explanation of why a claim makes sense and evidence that the claim is true. Epistemic understanding progresses developmentally, but substantial variation remains among adults, with few adults achieving understanding of the complementary strengths and weaknesses of evidence and explanation in argument. Epistemic understanding shapes intellectual values and hence the disposition (as opposed to competence) to exercise intellectual skills. Only its most advanced levels support a disposition to engage in the intellectual effort that reasoned argument entails. The sample case of juror reasoning illustrates how epistemic understanding underlies and shapes intellectual performance.     

Stories as Gift: Patient Narratives and the Development of Empathy

Critical thought and assessment of medical, emotional, and social problems faced by patients is central to genetic counselor training and development. However, primary emphasis on these critical problem-solving approaches can interfere with the development of empathic listening skills. Using a narrative medicine approach, I describe how learning to reframe one patient’s story of healing as a gift allowed me to become a more open and empathic listener. Ultimately, the empathy and understanding that I learned from this patient’s narrative added to what previous patients had taught me and helped me assist other patients (and myself) in identifying and nurturing healing narratives for people coping with illness and grief. The approach presented here emphasizes the importance of recognizing patients as valuable teachers in the development of higher-level empathy skills.