医患关系中的法律家长主义

发布时间：2018-06-01 05:31

本文选题：医患关系 + 法律家长主义　；参考：《吉林大学》2012年硕士论文

【摘要】：医患关系中存在着一种医疗家长主义调整方式，存在于私人之间且从患者利益出发，而法律家长主义是一种由法律对行为人自由进行合理干预的方式，这一干预方式应用到医患关系当中去便有了其独特的含义：基于患者的利益而对其进行法律的干预。这种干预建立在尊重患者自主权利基础之上，是一种适当有限的干预，同时又对患者利益进行风险预测的法律干预。医患关系中的法律家长主义是一种审慎的合理干预方式。全文分为四个部分。第一部分从医学、医患关系以及法律家长主义的概念特性来阐释医患关系中的法律家长主义不同之处。医学领域由具有神秘色彩的巫医巫术发展而来，是一门专业性很强的学科。医学这一特性使得医生因掌握技术而天然的处于强势地位，也就有了传统的家长制来对待处于弱势地位的患者。而对于医患关系有了“视患为亲”伦理上的意义，也有了对于医患关系进行不断的探讨，研究医患关系应该适用什么样的关系，包括纵向的不同学科和横向即医学内部的医患关系模式研究。法律家长主义运用到医患关系当中正是由于对医患关系不断探索的结果。尽管法律家长主义在不同领域内都是不同程度的干预，但是医患关系中的法律家长主义具有其独特之处：首先是对于私域的个人行为之间的调整；其次这种法律家长主义相对于原有医疗家长主义是一种适度谨慎的干预。医患关系中的法律家长主义建立在尊重患者自主权基础之上的理论，针对医患关系的特性，法律家长主义具有更强的适用性。第二部分从行为能力入手并结合案例对医患关系中的法律家长主义进行了类型分析。对于行为能力的认定具有重要的意义，因为行为能力是私域当中个体自治的基础，也是患者自主权的行使成为可能。不同的行为能力，法律家长主义也有不同程度与不同方式的干预。对于具有完全行为能力的患者而言，拥有更多自主的权利，但是并不意味着是完全的自主权，因为患者在疾病的折磨之下，在精神和心理上都会呈现弱势的状态，此时如果有患者自己做出决定，有可能会使医生推托责任，也是患者难以达到真正的自主决定，因而在特定的条件下应该允许法律为其利益而进行的干预；对于无行为能力和限制行为能力人而言，患者本身不能够做出自主的决定，而这种权利主要集中于其父母或者家属以及其他代理人身上，其父母或者家属在决定的权利上可能会受到其他因素的影响，此时在患者的利益可能会受到伤害的情况下，，法律家长主义有必要进行适当的干预，维护患者的最佳利益。本部分主要结合了因信仰拒绝输血的案例，缺陷新生儿以及中国比较典型的肖志军案件对法律家长主义干预进行了分析并对不同行为能力的患者干预范围进行了归纳。第三部分探讨了医患关系中法律家长主义适用的标准。主要从三个标准进行分析：第一是法律“引导式”干预。这点阐述的是建立在尊重患者自主权和知情同意权基础上，将传统的医疗家长主义转变为一种引导式的干预，即医生在同患者商议的前提下，对于一些适合患者治疗方案和方法进行建议和引领，使得患者得到最佳状态的治疗；第二是法律干预应符合适当比例的原则。比例原则是行政法中重要的原则，核心词强调的适当、适度，这一点同样可以应用到医患关系中。法律家长主义干预手段应基于患者利益为目的，其干预所带来的利益应超过其所带来的损害；第三是法律对于医疗中风险的预测与规避。这里要求在遇有紧急情况时，法律对于这种风险应进行准确的预测，并积极的帮助患者规避风险，这是医患关系中法律家长主义的最终目的和干预的合法依据。第四部分是对全文的梳理与总结。
[Abstract]:There is a way of adjusting medical paternalism in the relationship between doctors and patients. It exists between the private and the interests of the patients. The legal paternalism is a way of rational intervention by the law to the freedom of the perpetrator. This intervention has its unique meaning: Based on the interests of the patient. The intervention based on the law, which is based on respect for the rights of the patient, is an appropriate and limited intervention and a legal intervention for the risk prediction of the interests of the patient. The legal paternalism in the doctor-patient relationship is a prudent and reasonable intervention. The full text is divided into four parts.
The first part explains the differences in the legal paternalism in the doctor-patient relationship from the concept of medicine, doctor-patient relationship and legal paternalism. The medical field is developed from the mystical witch witchcraft. It is a highly specialized subject. The characteristic of medicine makes the doctor strong in mastering the technology. There is a traditional patriarchal system to treat patients in a disadvantaged position, and the relationship between doctors and patients is ethical and the relationship between doctors and patients is continuously discussed, and what kind of relationship should be applied to the relationship between doctors and patients, including the relationship between the longitudinal different subjects and the medical relationship within the medicine. Pattern study. The application of legal paternalism to the doctor-patient relationship is the result of the continuous exploration of the relationship between doctors and patients. Although the legal paternalism intervened in different fields in different fields, the legal paternalism in the doctor-patient relationship has its unique features: first, the adjustment of personal behavior between the private areas; Secondly, the legal paternalism is a moderate and prudent intervention relative to the original medical paternalism. The legal paternalism in the doctor-patient relationship is based on the theory of respecting the autonomy of the patient. In view of the characteristics of the doctor-patient relationship, the legal paternalism has a stronger applicability.
The second part makes a type analysis of the legal paternalism in the doctor-patient relationship from the behavior ability and combined with the case. It is of great significance to the identification of the behavior ability, because the behavior ability is the basis of individual autonomy in the private domain, and the exercise of the patient's autonomy is possible. Different behavioral abilities and legal paternalism also There are different degrees and different ways of intervention. For patients with complete behavior, there is more autonomy, but it does not mean that it is complete autonomy, because the patient is mentally and mentally disadvantaged under the suffering of the disease, and if a patient makes a decision, it may make it possible to make a decision. The doctor's responsibility is also difficult for a patient to achieve a genuine autonomous decision, so that the law should be allowed to intervene in the interests of the law under certain conditions; for those who are not able to do so, the patient itself cannot make an autonomous decision, and this right is mainly concentrated on their parents or their families and their own. On his agent, his parents or family members may be affected by other factors in the right to decide. At this time, when the interests of the patient may be hurt, the legal paternalism is necessary to intervene properly to maintain the best interests of the patient. This part should be combined with a case of refusing a blood transfusion by faith and a new defect. The children and the typical Xiao Zhijun case in China have analyzed the legal paternalism intervention and summarized the scope of the intervention for the patients with different behavior abilities.
The third part discusses the standard of the application of the legal paternalism in the doctor-patient relationship. The first is the analysis of the three standards: first, the "guiding" intervention of the law. This is an exposition of the transformation of traditional medical paternalism into a guide type on the basis of respecting the rights of the patient and the right to informed consent, that is, the doctor is in the same way. On the premise of patient consultation, some suggestions and guidance are made for the treatment scheme and method suitable for patients to make the patient get the best state of treatment; the second is the principle that the legal intervention should conform to the appropriate proportion. The principle of proportion is the important principle in the administrative law, the core word emphasizes appropriate and moderate, which can also be applied to the doctor and patient. In the relationship, the means of legal paternalism should be based on the interests of the patient, and the benefit of the intervention should exceed the damage it brings; third is the law's prediction and avoidance of the risk in the medical treatment. Risk avoidance is the legal basis for the ultimate purpose of legal paternalism and intervention in the doctor-patient relationship.
The fourth part is the carding and summary of the full text.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：D909.2

【参考文献】