Ms. Zhang, 76, went to the Eye Hospital of China Academy of Traditional Chinese Medicine five months ago because of blurred vision, and asked for cataract phacoemulsification compound implantation in both eyes. After examination by the hospital, it was found that Ms. Zhang suffered from Sheehan's syndrome, hypertension, polycystic kidney disease, unexplained anemia, coronary heart disease, pericardial effusion, cardiac insufficiency and other diseases in addition to senile cataract. Doctors believe that the patient is a contraindication of phacoemulsification combined with intraocular lens implantation under the existing circumstances, so they have repeatedly explained to the patient's family that the patient is not suitable for surgery, but the patient and his family still insist on phacoemulsification combined with implantation, and declare that all the adverse consequences caused by this are borne by the patient and his family, and have nothing to do with the hospital and the competent doctor.
In this case, both doctors and patients made notarial certificate of operation, which was notarized in the notary office of Shijingshan District, Beijing. Notarial Certificate The Chinese Medicine Hospital listed the dangers and possible accidents of 12 operations, and finally stressed that the hospital and the competent doctor would not bear any legal responsibility if an accident and the above-mentioned critical situation occurred, or the patient's original illness worsened, resulting in the death of the patient. The hospital and the attending doctor do not bear any medical and rescue expenses for the above-mentioned medical process and the complications arising therefrom, and the patients and their families take the initiative to bear all consequences and responsibilities.
Fortunately, the operation was finally successful, and the first operation notarization in Beijing drew a satisfactory full stop.
The notarization of surgery won the praise of doctors.
After the matter was disclosed by the media, it was immediately praised by hospitals and medical staff. A doctor in Beijing said: "The notarization of surgery is equivalent to advancing the medical appraisal afterwards, so that patients can know all possible situations in advance, which can be said to be an effective means to reduce medical disputes." Some doctors say: the notarization of surgery can make doctors go into battle lightly, turn pressure into motivation, and give full play to technology and potential. Some media even listed several advantages, such as: first, patients are fully informed and fully prepared for various possible accidents. Once an accident happens, patients and their families can easily adjust their psychological state. The second is that notarization has legal basis in behavior, facts and documents, which makes medical staff go into battle lightly and actively save patients. Thirdly, in the event of an unexpected and notarized accident, there is a contradiction between doctors and patients, and a legally effective third party will make a ruling from the standpoint of legal justice, which is easy to coordinate differences.
Lawyer said: Notarization cannot reduce medical disputes.
Huang Xiao, a lawyer of Beijing Fadu Law Firm, believes that for doctors and hospitals, saving lives is the basic embodiment of their functions, and technical accidents or liability accidents in medical treatment should bear corresponding legal responsibilities. This is the law, and both doctors and patients cannot exempt one party from fault liability through agreement, let alone put on the legal coat of notarization.
"Notarization" only plays a role in strengthening the legal effect of evidence in law, and the notarized agreement must be legal first. It is illegal for doctors and patients to agree that Chinese medicine hospitals are "irresponsible" Taking advantage of the patient's eagerness for surgery to force him to sign a contract is even more suspected of "taking advantage of others' danger", and the agreement of "taking advantage of others' danger" is invalid in law. In fact, "notarization" can not reduce the disputes between doctors and patients, but may reduce the responsibility of medical staff. In addition, this unfair and illegal notarization may intensify the contradiction between doctors and patients, make patients distrust doctors and hospitals, and lead to vicious violence.
Patient said: Medical notarization is unreasonable.
Teacher Yang Shaode, a senior teacher in Beijing, believes that it is impossible for hospitals to require pre-operative notarization for patients with acute and severe diseases. As we all know, every minute saves lives. Notarization requires both doctors and patients to sign in the notary office, and even if the notary goes to the hospital to work on the spot, it will take some time, which is not good for saving lives and does not conform to the principle of saving lives. For people who don't understand notarization, it is easy to misunderstand that "medical disputes are solved by notary offices". In fact, notarization only examines and confirms the contents of the agreement and is not responsible for the subsequent medical process. However, the notary office doesn't know much about medical technology. If there is a medical dispute, it still needs the health administrative department and the medical accident appraisal committee to solve it.
Another retired teacher, Mr. Lu, thinks: from the patient's point of view, we don't approve of notarization. The hospital is a unit to heal the wounded and rescue the dying. People-oriented, not medical disputes.
The Law on Medical Practitioners stipulates that first aid treatment shall not be refused.
Article 24 of Chapter III "Practice Rules" of the Law of People's Republic of China (PRC) on Medical Practitioners stipulates that doctors should take emergency measures for the diagnosis and treatment of critically ill patients and may not refuse first aid. Article 37 of Chapter V "Legal Liability" of the Law stipulates that "irresponsible delay in the rescue and diagnosis of critically ill patients, resulting in serious consequences", the health administrative department of the people's government at or above the county level shall give a warning or order it to suspend its practice for more than 6 months 1 year; If the circumstances are serious, his practice certificate shall be revoked; If a crime is constituted, criminal responsibility shall be investigated according to law.
Judging from the above legal provisions, it is against the Physician Law for hospitals to treat critically ill patients on the condition of "pre-operation notarization".
Reducing disputes between doctors and patients should start from the hospital itself.
In view of the increasingly acute contradiction between doctors and patients and the constant disputes, Li Ning, vice president of Beijing Chaoyang Hospital, believes that in order to reduce disputes and ease contradictions, the medical industry should start from itself, first of all, standardize its own behavior, respect the rights and interests of patients, improve medical services, and actively accept patient supervision. According to Vice President Li, in the past, doctors' explanations of surgery before operation were often simple and blunt, with little attention paid to patients' rights and interests. Now Chaoyang Hospital has re-established the service standard. Before operation, it is necessary to explain the situation in detail to patients and their families, communicate fully, and hold a heart-to-heart meeting with patients and their families when necessary. Although this kind of preoperative communication has been extended from ten minutes to one or two hours now, it seems to be more troublesome for doctors, but it actually avoids unnecessary disputes after surgery. This measure has been recognized by both doctors and patients for half a year.
Practice in Chaoyang Hospital has proved that notarization of surgery is not the only magic weapon to solve disputes between doctors and patients. If hospitals and medical staff practice medicine according to law, fully protect and respect patients' rights and interests, and standardize medical behavior, disputes can be reduced, contradictions can be alleviated, and patients can be better served.
The First Notarization of Surgery in China and Its Derivation
In 2000, a patient with congenital serious eye diseases was blind in one eye, and the retina of the other eye fell off and bled, so he would be blind if he didn't have surgery immediately. The patient went to several hospitals for treatment, but they were not rescued because of the high medical risk. At the pleading of patients and their families, Xishan Hospital of Jiangsu Province decided to operate on them. Although the patient's family members have repeatedly said that the hospital will not be responsible for the failure of the operation, the hospital still insists on signing a medical agreement with the patient and notarizing it by the notary office.
Subsequently, a large hospital in Chengdu, Sichuan Province, learned from the experience of Jiangsu, and proposed that before critically ill patients were pushed into the operating room, the hospital and their families signed relevant agreements, stipulating that "the hospital will operate according to normal treatment methods, and the hospital will not be responsible for any accidents during the operation". Then the agreement can have legal effect after notarization by the notary office.