基于患者最佳利益原则完善我国医疗委托代理制度

Perfecting the medical entrusted-agent system based on the principle of patients’ best interests

医疗决定权是以患者的人格利益为客体,不仅与患者的生命健康密切相关,更是患者主体性和人格尊严的体现,应以患者本人行使为原则。医疗决定权代理行使的理论基础在于委托代理理论和私法领域的意思自治原则,但其代理行使仍应当有着严格的限制。然而当前国内医疗委托代理制度在对患者自主决定权的法律确认与保障、委托代理双方主体范围确定、授权委托的时间效力、代理权行使的限制等方面还存在着缺陷。作者以“患者最佳利益”原则为出发点和落脚点,针对制度的现有缺陷,从明确授权委托主体、委托行为效力认定、限制代理权行使等方面来探讨医疗委托代理制度,以期在医疗委托代理中最大程度保障患者生命健康权的同时,尽最大可能保障其作为法律关系主体的人格尊严需求。

Medical decision-making right is based on the patient’s personality interests,which is not only closely related to the patient’s life and health,but also a manifestation of the patient’s subjectivity and personal dignity,and should be exercised by the patient himself.The theoretical basis of its agency exercise lies in the entrusted-agent theory and the principle of autonomy of will in the field of private law,but the agency exercise of medical decision-making power should still have strict restrictions.However,the current medical agency system in China still has defects in the legal confirmation and protection of the patient’s right to make decisions,the determination of the scope of the entrusted-agent parties,the time effectiveness of the authorization,and the restrictions on the exercise of the agency rights.Taking The principle of ‘the best interests of patients’ as the starting point and goal,in view of the existing defects of the system,we will discuss the reconstruction of the medical entrusted-agency system from the aspects of clearly authorizing the entrusted subject,confirming the effectiveness of entrusted behavior,and restricting the exercise of agency rights,ect.,in order to maximize the protection of patients’ right to life and health,and at the same time,to maximize the protection of their personal dignity needs as the subject of legal relationship.