论紧急救治中患者近亲属意见的取得——评《医疗损害责任司法解释》第18条

Study on the Acquisition of the Patient's Close Relatives' Opinions in Emergency Treatment——Reviewing the Article 18 of the Judicial Interpretation of Medical Damage Liability

《医疗损害责任司法解释》第18条设计的紧急救治中患者近亲属意见的取得制度未规定近亲属参与医疗决定的顺位、未构建近亲属内部意见冲突的解决机制及未明确近亲属代理决定的权限限制制度,可能徒增医疗决策成本、降低医疗决策效率、违背患者的最真实意愿及损害患者的最佳利益。我国应当采用法定顺位制的近亲属代理决定模式,规定同顺位的近亲属之决策冲突的多数决规则及明显不利于患者利益之近亲属意见的限制制度,以最大程度地尊重患者的意愿、最大限度地保护患者的利益及最合理地平衡患者自主权、近亲属代理权与医务人员救治义务的关系。

In the Article 18 of the Judicial Interpretation of Liability for Medical Damage,the system of obtaining patient＇ s close relatives＇ opinions in emergency treatment is not stipulated the order of close relatives participation in medical decision, the settlement mechanism of the internal conflict of opinions between close relatives and the restrictive system of the authority of the close relatives agency decision,which may increase the cost of medical decision,reduce the efficiency of medical decision,and violate the real desire of patients as well as the best benefit of patients. Our country should adopt a legally-ordered close relatives ＇ agency decision model,stipulate a majority rule which is in the conflicts with the decisions of close relatives in the same position,and set a rule that restricts the close relatives＇ opinion which is obviously unfavorable to the benefit of the patients,so that respect the patient＇s will maximally,protect the benefit of patients well and balance the relationship among patient autonomy,agency right of close relatives and medical personnel ＇s duty of treatment most reasonable.