医疗损害责任纠纷中违反医疗告知义务的相关问题探讨

Discussion on Violation of Medical Notification Obligation in Medical Damage Liability Disputes

目的分析在司法实践中违反告知义务的相关情形及在医疗损害后果中的原因力,探讨如何审慎履行告知说明义务,以期为医疗实践中医方做好告知说明义务、维护医患双方合法权益提供一定参考。方法对“中国裁判文书网”公布的北京市2022年涉及违反告知义务的医疗损害责任纠纷案件57例进行统计分析。结果涉案医疗机构中三级医院占比最高,为84.21%;诊疗过错行为在损害后果中原因力大小被判定为“次要原因”案件占比最高,为33.33%,其次是判定为“轻微原因”的案件有18例,占比为31.58%;违反告知义务过错情形中“未履行充分告知义务”的案例最多,占71.93%(41例)。结论在医疗实践中,如何履行适当的说明告知应引起医疗机构的重视。加强相关法律法规及案例培训,强化告知事项,注重质控动态管理,加强医患沟通培训等措施有助于防范风险。

Objective To analyze the relevant situations of violation of notification obligation in judicial practice and the causation of medical damage consequences,and to explore how to prudently perform the notification obligation,so as to provide some reference for medical service providers to fulfill the notification obligation in medical practice and safeguard the legitimate rights and interests of both doctors and patients.Methods A statistical analysis was made on 57 cases of medical damage liability disputes involving violation of notification obligation in Beijing in 2022 published on"China Judgment Documents Network".Results Tertiary hospitals accounted for 84.21%of the involved medical institutions.Among the consequences of damage caused by fault behavior in diagnosis and treatment,the causation judged as"secondary cause"accounted for the highest proportion of 33.33%,followed by 18 cases of"minor cause",accounting for 31.58%.Among the fault situations of violating the notification obligation,the cases of"not performing the full notification obligation"were the most,accounting for 71.93%(41 cases).Conclusion In medical practice,medical institutions should pay more attention to how to perform proper notification.Strengthening relevant laws and regulations and case training,strengthening notification matters,paying attention to dynamic quality control management,strengthening doctor-patient communication training and other measures would be conductive to risk prevention.