美国医疗无效纠纷解决机制及其对我国的启示

Enlightenment of American Medical Futility Dispute Resolution Mechanism to China

医疗无效和医疗无效纠纷现已成为美国卫生保健领域内最具争议性的问题之一,其核心为医疗无效纠纷的解决。经过约三十年的发展,美国已构建了一个多主体参与的、立体的医疗无效纠纷解决机制,主要包括预先医疗指示、医院医疗无效政策的披露、医院伦理委员会机制、更换机制、单边行动机制、诉讼机制和其他一些非正式纠纷解决机制。美国医疗无效纠纷解决机制中对医生伦理权利和患者权利的限制与平衡、纠纷解决过程中的多主体参与和医院伦理委员会的作用,对我国的研究有重要的启示意义。

Medical futility and medical futility disputes have become one of the most contentious issues in American health care, and the core is the resolution of the invalid disputes. After about 30 years of development, the United States has established multi-bodies participated and cubic dispute resolution mechanisms for medical futility disputes, including advance directives, disclosure of the hospital medical futility policies, hospital ethics committee mechanism, replacement mechanism, unilateral action mechanism, litigation mechanism and other in- formal dispute resolution mechanisms. The restricting and balancing between physician＇s ethics right and patient＇s fight and multi-bodies participation and the role of the hospital ethics committees in American medical futility dispute resolution mechanisms are of great significance for China.