The Connection Between Medical Self-determination and the System of Adult Guardianship——The Institutional Construction of Medical Proxy

China has established the basic rules of informed consent in the medical field through Articles 1219 and 1220 of the tort liability part of the Civil Code of China to address the legality of medical conduct.Since patients’capacity to consent is the prerequisite,when the patient is a fully competent person,it is sufficient to give consent based on valid notification by the doctor.However,for those who are unable to give valid consent,especially adult patients with impaired capacity,resolving the legality of the doctor’s medical conduct remains an issue when it infringes on the patient’s body and health.To solve this issue,someone must give consent in place of the patient when the adult is unable to give valid consent.However,the personal and exclusive nature of the right to medical consent,which is informed consent,makes it impossible to simply delegate it to a guardian or other person to exercise it on behalf of the patient.In this paper,we borrow the concept of“medical proxy”proposed by Japanese scholar Teruaki Tayama,and for the first time,we discuss the construction of medical proxy from the perspective of adult guardianship by connecting the two systems from the standpoint of interpretive theory.

Reflections on the Guardianship and Support System of the Elderly Under the Background of an Aging Society

China Is aging society poses new challenges to guardianship system in the General Rules of the Civil Law of the People s Republic of China.The General Provisions of the Civil Law adapts to the requirements of the times and makes some important amendments and supplements to the guardianship system,notably the scope of adults with civil disability or limited capacity for civil conduct is no longer limited to people with a mental illness.However,there remain many deficiencies in the regulations.Based on the framework provisions of the existing guardianship system of the General Provisions of Civil Law,in the compilation of the marrage and family provisions in the Civil Code,it is necessary to strengthen the protection of the rights and interests of the elderly in an aging society,further improve the elderly guardianship system,including changing the single pattern of the guardianship system and improving the"dual subject"pattern of adult guardianship and adult support system,expand the scope of protected subject of guardianship,and improve the existing system of intentional custody,adult guardianship system,and guardianship and supervision system.

Protection of the Human Rights of Those Under Guardianship in the General Provisions of the Civil Law

Based on the guardianship system in the General Principles of the Civil Law, the General Provisions of the Civil Law establish the three concepts of respecting the true will of the ward, benefiting the ward to the greatest extent, and moderate intervention of public power in guardianship. The three concepts are embodied in the specific provisions of the guardianship system, highlighting respect for and protection of human rights under the spirit of the Constitution as well as the human rights concept of protecting the interests of this vulnerable group, improving the scope of protecting the human rights of minors, the disabled and the elderly in the Chinese guardianship system. The General Provisions of the Civil Law expand the functions and types of the guardianship system, enrich and perfect the guardianship system for minors, and clearly stipulate the conditions and means for disqualifying guardians, and arranging temporary custody and state custody. They expand the scope of guardianship for minors, respond to the reality of increasing guardianship needs and the aging of Chinese society, dovetail with the international community’s concept of respecting and safeguarding the rights of the elderly and adults with disabilities, and reflect the law moving with the times. The Specific Provisions on Marriage and Family under the General Provisions of the Civil Law now being compiled should refine and enrich the guardianship system under the framework of the guardianship system in the General Provisions, so that they become the rules of conduct that is practically feasible and enforceable in judgments.

Rural child care situation

This group of children left in rural areas due to lack of proper care,custody, guardianship systems now in existence and imperfection of the legal.From the existing left-behind children in rural China based on the type of guardianship,custody of children left in rural areas briefly outlined the situation,analyzes the various problems the guardianship of them,emphasizing the importance of the establishment of the system of guardianship,and the feasibility of establishing child guardianship system puts a series of targeted recommendations aimed at creating better environment for the healthy growth of children.

老年人脑中风社区防治4类典型病案小结187例

目的:高血压脑中风社区防治是国家级攻关项目。对高血压脑中风患者187例进行社区临床监护,分重危、重点、一般3类监护;结合个人体质制定中西医个体预防调节方案。按照季节,个人超前预防调节。记录个人每年体检数据,深究失查漏洞。宣传养生预防知识,使其成为群众个人自觉行动。经结合学习各地先进经验后,更加提高了科学性和自觉性。本文对中医发病4大类型各选出典型病例进行小结,共同研讨交流经验和教训。

Governance of Violence Risk in Patients with Severe Mental Disorders:From a Case of a Schizophrenic’s Filicide

Schizophrenia is a chronic,prolonged illness with a significant tendency to relapse and a high disease burden.Patients are often affected by psychotic symptoms and commit violent assaults that manifest as criminal acts.At the same time,such patients generally have poor medication adherence,which also makes them more likely to commit crimes.In our case,a single mother with a history of psychiatric illness strangled her 4-year-old biological son to death with a rope,put the body in a bathtub and divided it,ate some of the victim’s organs;the results of her forensic mental health identification indicated she was in a period of illness at the time of the offense and did not have the competence for criminal responsibility.Medication adherence is an important factor affecting relapse in patients with schizophrenia.Although new medications have been introduced and researchers have been improving medication adherence through many ways such as patient education and family therapy since the 1980s,the level of medication adherence is still poor,with a nonadherence rate of about 50%.This report suggests that in practice,attention should be given to improving patients’medication adherence,guardians of patients and their communities should strengthen their monitoring and care,including knowing the patients’medication adherence and monitoring them to take their medication as prescribed,together with systematic psychotherapy for patients to prevent them from relapsing and committing violent attacks.Besides,when assessing the patient’s risk of violence,the realistic factors in crime motives and the impact of guardians(family)should be taken into account to evaluate the risk of violence objectively and comprehensively.A final point is that social support for patients with mental disorders and their families should be improved.