精神康复中医疗告知的形式——基于精神卫生法视角

Medical Notification Form in Mental Rehabilitation——Based on the Perspective of Mental Health Law

法律对医疗机构规定告知义务条款,是为了维护患者(含就诊者、患者、患者监护人)知情权、选择权,彰显现代社会对人的“自主权”的保障。临床实践中,医疗机构履行告知义务,既要在实质上实现患者知情,还要在形式上表明完成“履责”,即在法律层面上医疗机构的告知义务履行需达到内容和形式上患者知情权的实现。《中华人民共和国精神卫生法》中8项条款从11个方面规定了医疗机构的告知义务,涉及患者检查、治疗、住院、出院等环节和不特定人群的精神科就诊、精神检查、是否住院医学观察等内容;因其告知内容的丰富、告知对象的多元化,实现告知义务的完全履行对告知形式的要求具有代表意义。该文梳理常见医疗告知形式的特点,总结并分析医疗机构履行精神卫生法规定的医疗告知义务经常面临的两种情形,即告知形式选择的冲突和告知义务实践分歧,指出履行医疗告知义务的价值不仅体现在法律的责任上,更应关注其医学伦理和人文关怀意义,也应作为医疗机构解决实践困惑的根本遵循。

The law stipulates the obligation of notification to medical institutions,which is intended to maintain the right of patients to know and choose,and highlight the safeguard of modern society for human autonomy.In clinical practice,medical institutions fulfill the obligation of notification,which not only realizes that the patient is informed,but also indicates the completion of"fulfillment of responsibilities"in form.The 8 articles in the"Mental Health Law of the People's Republic of China"stipulate the notification obligations of medical institutions from 11 aspects,involving patient inspection,treatment,hospitalization,discharge and other steps,as well as the psychiatric department consultation and psychiatric examination of unspecified population,whether they are hospitalized for medical observation and other content;because of the rich content of the notification and the diversity of the notified objects,realizing the complete fulfillment of the notification obligation had a representative significance for the requirements of the notification form.This article sorts out the characteristics of common medical notification forms,summarizes and analyzes two situations that medical institutions often encounter when fulfilling their medical notification obligations under the Mental Health Law,points out that the value of fulfilling medical notification obligations is not only reflected in legal responsibilities,but also should pay attention to their medical ethics and humanistic care significance,and should be the fundamental principle for medical institutions to solve practical difficulties.