| Objective: The provisions of the previous law on the effective exercise of the right of informed consent of patients with acute emergency have not yet clear.Article 56 of the Tort Liability Act,which came into effect in 2010,provides for a further clarification of some of the elements,but it merely states the condition when "the informed consent of patients or their close relatives cannot be obtained" and fails to cover the condition when the patient(or relatives)has informed consent but decides to violate the medical science obviously.This study intended to investigate the differences of opinions between different groups in the treatment of physician’s for patients who are too critically ill to obtain informed consent,and the comparison of the differences between the social cognition and the current law in order to provide evidence of the possible necessity to improve the system of informed consent right of patient in China.Methods: This study adopted the empirical research method of the questionnaire design and survey after literature review and related case analysis.Based on the current "Tort Liability Law",through the stratified random sampling on three groups of people(physicians,legal person,the community(the patient or family))in Chongqing,Luzhou or Zunyi,their opinions in the physician’s disposal on the patient who is too critical ill to obtain properly informed consent but needing medical rescue treatments which may offer opportunity to save their lives or preserve parts of their body were investigated.The survey indicators mainly include the selection of the various physicians’ disposal methods in six presuppositions related to the above conditions,and the differences between groups and regions.The number of samples was calculated with pre-survey,and the data were analyzed using row × list χ2 test or Fisher’s exact probability method with bidirectional disorder R × C table.P<0.05 was considered statistically significant.Combined with the survey results and legal analysis,specific recommendations and processes were put forward.Results: The minimum sample size was estimated to be 406 cases,600 cases were issued and 559 cases were recovered.The recovery rate was 93%.The difference between the three groups was statistically significant(P<0.05),but there was no significant difference between the three regions(P>0.05)regarding each presupposition.According to the combined data,when the patient was disagreed with the views of the family or the patient was unable to express but the family refused to rescue,or opinions were inconsistent among family members,or the family refused to sign,or no family were available,the majority of respondents selected to "respect for the physician opinion"(the percentages were 65.47%,58.68%,72.81%,82.11%,and 93.20%,respectively).The choice of people who respected for physicians’ opinion tended to support the participation of a third-party in decision-making.Conclusion: Different groups agree that when patients are in critical condition and cannot obtain effective informed consent,their right of informed consent should be restricted,their right of life and health should be given priority to,and they should be treated appropriately.Related laws are to be improved:(1)to confirm that "the opinion of a patient or close relatives clearly violates medical science or ethics when the patient is in critical condition” shall be deemed to be in conformity with the Tort Liability Act;(2)to include emergency treatment in statutory exemptions and the consequent mitigation of liability for damage;(3)to judge the ability of patients to express their willingness with civil capacity standards,establish the supervising mechanism of emergency treatment of medical institutions,and avoid abuse of rights. |
PDF Full Text Request