实施知情同意 防范医疗争议

Implementing the system of informed consent so as to guard against medical disputes

医疗服务中 ,常有医患双方因为对服务期望的不同意见导致的矛盾冲突 ,甚至形成医疗争议 ,问题源于医患法律关系的基本定位及其特殊性。医患法律关系基本定位为民事法律关系 ,被视为医疗服务合同。与其他服务合同相比 ,由于医疗服务的个性化特点和损害特性 ,医疗服务合同在需要医患双方认识达成一致的合同标的、履行方式和数量频次、合同履行风险、以及服务所需时间期限和费用等主要的合同元素方面则是严重残缺的。为了维护医患双方的合法权益 ,作者提出了在医疗服务的各个不同阶段 ,通过知情同意对医疗服务合同进行完善和补充 ,以防范和减少医疗争议发生的思路 ,分析了知情同意的重要意义和目前存在的主要问题 ,并且就告知的内容、范围、主体、对象、方式、证据等具体操作和管理问题提出了切实可行的建议。

In medical service disagreement or even medical disputes often arise between doctors and patients because of their different views on expected service. The root of the problem lies in the special legal relationship between the two. Compared with other service contracts,medical service contracts,due to the featute of individuality and the nature of possible damage of medical service, greatly lack doctor-patient agreement on such key elements as the goal of the contract, the manner and frequency of implementation, the risks involved, and the time and cost needed. To uphold the legal rights and interests of both sides, the authors suggest that in each of the varrious stages of medical service, the system of informed consent be used to perfect and supplement the medical service contract so as to guard against and reduce the possibility of medical disputes. They also analyze the significance of the system of informed consent and the main problems that currently exist and put forward viable suggestions with regard to the contents, scope, subjects,objects, manner and evidence of information.