Foreign surgery signature: Life-to-upside rules in crisis time make way

husband refused to sign thepregnant woman diedhospitalAfter the tragedy, the community has a fierce debate about this, the deceased's husband can not operate to save people without signing? According to the existing legislation of our country, the operation must be carried out with the consent of the patient, and the consent and signature of the family member, if the patient's opinion cannot be obtained, the consent and signature of the family member shall be obtained, the patient's opinion cannot be obtained and no family member is present, the physician shall propose a medical plan and implement it after obtaining the approval of the person in charge of the medical institution or the person authorized by the person in charge of the medical institutionWhen life is at stake, who is to make the final decision and who is responsible for life? A doctor? Patients? Or family? How do foreign doctors behave at this point? In order to find out this particular and complex key issue, this reporter not only interviewed doctors and related experts such as ThemeY, but also carefully looked for the corresponding laws and regulations abroadAustralia and Japan also have pre-surgery signed "rules"with similarpatients or immediate family members in The Country do not sign Japanese doctors do not operate
At present, theHospitalin Japan will require the patient himself or his spouse and other immediate family members to sign the letter of responsibility before performing surgery, if not the immediate family members provided for by law, such as the cohabitation nature of the marriage certificate, the so-called "couple" relationship, will be firmly rejected by the hospital, will be in accordance with the provisions of the Civil LawStrictly speaking, this requirement in Japan does not have a clear legal provision, the hospital is mainly based on the Ministry of Health, Labour (equivalent to China's Ministry of Health) issued a number of documents, and thus formed the industry agreed to the "rules." However, once the patient's family has signed the letter of responsibility for treatment, it is considered to be a legally recognized relationship between the doctor and patientIn the event of a failure of medical surgery in the future or a default on medical expenses by the patient, both doctors and patients may hold a letter of responsibility to make the relevant legal claimIn addition to the economic risks, the Japanese medical community for fear of taking the risk of failure of surgery to eat a lawsuit, in the case of the patient himself or immediate family members refused to sign the letter of responsibility, the hospital will refuse to operate on the patientA legal expert cited a case in which the patient was left breast cancer, and during the operation, the doctor examined his right breast and found that the risk of breast cancer on this side was very high, so the doctor cut off the patient's right breast for safety reasonsThe incident was brought to court by the patient, who held that the hospital had decided to remove tissue organs without the consent of the patient or his relatives, and therefore awarded the hospital substantial financial losses to the patientLooking at this case, it seems that the Japanese medical community so attached so much importance to preoperative signature signed a further understandingWhen it comes to surgical signatures, the Japanese medical community is doing the same thing as ChinaIn addition, Japan has an additional postoperative signature system, whereby signed immediate family members have to wait in hospital for the operation to be completed before signing the resultsAustralian surgery needs to be signed by himself or relativesin Australia, if the patient is conscious before the operation, is sober, the doctor should follow the patient's own wishes;For example, a patient was in a coma in a car accident and taken to a hospital, where the family was away, and the doctor decided whether to operateIf you need to sign before surgery, the first choice is the spouse, then the parents, if not, the friend can also signIn addition, before the operation, if the doctor explains to the patient and the signatory the danger of the operation, the operation fails, the doctor is not responsibleOtherwise, the doctor is responsibleEurope and the United Stateslife-threatening doctors save people firstwhen the patient has the ability to decide when the treatment plan is signed only by the patient himself
the U.SConstitution respect simply the right to privacy of individuals also apply to the doctor-patient relationship
reporters from the United States to fight medical disputes from the lawyer sought from the doctor, he has the responsibility to provide his own health information, but also the right to decide what kind of treatment The operation is signed by the patient himself and the consent is carried out There is no requirement that hospitals have to obtain the consent of their families, as is also the case in other Western countries "For adults over the age of 18, the treatment is up to the patient, except for the patient's own prior statement," a British doctor said in an interview "Even though doctors sometimes downplay the severity of some of the conditions in order to comfort patients, all examinations and treatments need to be explained to the patient so that the patient knows the full process, including the length of the operation, the scope of anesthesia, rehabilitation plans, etc When a family member is required to make a decision the physician-patient relationship scribe of the United States provides that patients may, if necessary, entrust their lawyers, spouses, parents, adult children and siblings to make decisions on their behalf when they are unable to express themselves on their own The entrustment must be in writing, must be signed by the patient himself, and the oral entrustment must not be recognized The subject may be one or more persons, but cannot entrust a lawyer or family member at the same time With the patient's consent, his spouse and relatives can participate in understanding the treatment process Doctors are the first to seek the patient's own opinion, but also to refer to the wishes of the family, to avoid the patient too extreme If the patient is underage, the law requires the parent or guardian of a child under the age of 18 to make a treatment decision Doctors should explain everything to parents and guardians, but they cannot ignore the rights of minors Depending on the specific age and understanding of the patients, the hospital prepares the information and videos they can understand and allows them to participate in treatment interviews with their parents Often, doctors in the United States treat and treat patients in separate spaces, free from outsiders, and patiently answer patient questions from patients and their families, in a "I serve you, your demands are the first" attitude toward patients Doctors have a duty to help when life is endangered
in the United States, Canada, the United Kingdom, Italy, France, Germany and Spain, there is a public law, the Emergency Disaster Relief Act, also translated as the Law of Righteous Courage, which requires everyone to lend a helping hand in the event of a life-threatening disaster, including in the medical community The most obvious example is when, after Diana's car accident in France, French doctors rushed to the scene to save people, their actions were deemed lawful; The U.S Medical Law: Emergency Emergency Surgery Act states: "Doctors have the right to treat a patient without the patient's consent and without the permission of any other person when a patient is at risk of life or physical disability." "
in the event of a sudden disaster, the patient may lose his or her capacity, at this time, the doctor has the right to invoke the provisions of the Emergency Operations Regulations, to decide on the best means of care This is often seen in the emergency rooms of U.S hospitals, where decisions are considered legal, and when emergency measures are taken, doctors leave detailed records of treatment for later examination Doctors in Germany are known for their rigorous work, and they are active in persuading patients if they believe that treatment is necessary to treat them According to a 2006 survey, 80 per cent of patients in Germany rated the level of hospital and doctor services well The German doctor, who is currently working at an emergency centre in Beijing, said: "The German doctor needs a patient's signature before the operation, but if the patient's life is endangered, the German doctor will be the first person to save his life, and the doctor in charge will be responsible." "
a British emergency room doctor said: "In times of crisis, doctors have the power to decide on emergency treatment options "Hospitals in the UK are also led by consultant physicians, with a team of doctors studying treatment options to reduce the pressure on individual doctors Doctors in France have careful humane care for patients in their treatment, and will explain them in detail before and after surgery, including risk statements, and the operation does not require a family signature When a doctor mishandles a mistake, he or she must be held liable for the fault
U.S law allows a spouse or family member to sign off on a treatment plan when the patient is unconscious However, the doctor shall not use the signature of the family member to consent to the operation and medication after the accident as a basis for shirking the responsibility Therefore, it is not that doctors do their best in dealing with emergencies to ignore the interests and safety of patients For example, there was a medical accident in Michigan in 2000 At that time, a pregnant woman in critical condition, the fetus in the abdomen due to disease almost suffocated, the doctor decided to give the pregnant woman surgery to remove the baby But the operation touched the nerve in the child's arm and he was ordered to pay huge compensation At the hearing, the court asked a third-party medical expert to make an assessment that the doctor's surgery in an emergency was necessary to save people, but at the same time asked the doctor's insurance company to come up with an insurance premium to cover the cost of the child's arm treatment In addition, most patients and their families do not understand medicine, their signatures, only the endorsement of treatment contracts, do not represent their commitment to accident responsibility, doctors in the knowledge of the dominant position, must be responsible for errors Doctors in the United States keep all written materials and are careful to prevent medical accidents And patients and family members if the "set up bureau" to marry the doctor to cheat compensation, once verified, but also to bear legal responsibility The bridge between doctors and patients - Professional social workers in American hospitals, in addition to doctors and nurses, there are a number of very important staff - hospital social workers, they are highly educated, psychological and legal knowledge of professional , is an important bridge between doctors and patients Hospital social workers usually appear when patients and their families are frightened, stressed and isolated, and are accompanied by doctors at the request of the patient as they explain the procedure These professionals are human, and their main role is to help doctors explain to what patients cannot understand, what risks they face, what legal protections they have and what responsibilities they have At the same time, it is much easier for doctors to explain the operation to experienced social workers than to explain the operation directly to patients and their families, and to reduce the pressure on them to take into account the emotional feelings of their families during the intensive operation, which will save a lot of time for social workers to communicate with patients and their families Moreover, hospital social workers are witnesses to medical disputes, which can effectively prevent "one side", and their testimony is also an important basis for the court to rule on medical disputes (Wang Kaihu Zhang Hexuan Jinjing Wenye Yushun)