Research On The Right Of Informed Consent Of Family Members Of Patients

From the regulations on the management of medical institutions to the tort liability law to the basic health care and health promotion law,the system of patients' informed consent right and the system of family members' informed consent right have been continuously developed and improved in China.The family members' informed consent right is considered as a supplement to the patients' informed consent right.However,due to the different provisions of laws and regulations on the application and exercise of the right of informed consent of family members,there are different understandings in theory and Practice on the nature,content,exercise conditions,protection methods of the right of informed consent of family members,as well as the relationship with the right of informed consent of patients and the relationship with medical privileges.At the same time,the current law does not regulate the exercise principle of the right of informed consent of family members,the scope of family members,the order among different family members,and the right holder's ability of informed consent.According to the existing regulations,there is no clear solution for patients,family members and medical institutions in the event of conflicts and disagreements.This may lead to untimely treatment,or even become an excuse for medical institutions not to act,resulting in the life,body and health of patients in a dangerous situation.The complexity of the source of the right of informed consent makes it impossible to generalize the nature of the right of informed consent.Only the right of informed consent obtained according to the written authorization of patients can be regarded as the scope of agency,and the right of informed consent based on guardianship system or voluntary guardianship system should be a duty.In addition,the right of informed consent should be the right to participate in decision-making.When the spouse,parents,adult children,brothers and sisters,grandparents,grandparents,adult grandchildren,and adult grandchildren are included in the scope of near relatives,the daughter-in-law and son-in-law living together can also be included in the scope of near relatives.At the same time,the right of informed consent of family members should be exercised in a clear order,and the status of a close relative,especially the status of spouse,should not be improved too much.The ability of informed consent cannot be equated with the capacity of civil conduct,and the ability of limited civil capacity to participate in medical decision-making should be properly recognized.For the exercise of the right of informed consent of familymembers,the principle of pure autonomy,the principle of alternative judgment and the principle of best interests guide the right of informed consent of family members in different situations.When patients,family members and medical institutions have conflicts,discuss and propose solutions based on different situations.When refusing medical treatment will damage the interests of the third party or the public interest,it should not be allowed to refuse.When there is a conflict between patients and their families,the principle should be to respect the patient's right of self-determination,but if it will lead to the loss of life of patients,it should be decided to listen to the opinions of patients or their families according to the severity of the disease.If there is a conflict of opinion between family members and medical institutions,and the patient loses self will,it is necessary to decide whether to take the opinion of family members refusing treatment according to whether the patient's state can be fundamentally changed after the implementation of medical behavior.At the same time,a judicial review system can be established to judge whether to implement medical decisions with the participation of professionals.