刑法视野下医疗行为中的患者同意问题研究

发布时间：2018-10-29 23:05

【摘要】：每个行为人的自主决定权都是他们尊严的体现,人们有权选择自己想要成为的样子,这种自我决定权在医疗过程中也有所展现。本文以阻却医疗行为违法性为视角,探讨患者同意的刑法问题。文章共分为五个部分,主要以医疗行为中的患者同意权为主线,依次讨论了医疗行为的概念、正当化依据、知情同意与自我决定权的关系、患者同意的构成要件、缺乏患者同意的医疗行为等问题。在第一部分中,笔者通过对医疗行为内涵外延的界定,得出医疗行为具有侵袭性的结论,由此引出对医疗行为正当化的分析,并将医疗行为区分为治疗行为与其他医疗行为,认为患者的同意才是阻却治疗行为违法性的核心;而对其他医疗行为是否具有正当性进行判断时,则应当把握多方面要件。在文章的第二部分,笔者阐释了自我决定权的哲学基础,认为知情同意原则是一种医疗领域内的自我决定权。第三部分是对有效患者同意的讨论,在同意主体的同意能力方面,笔者主张无需为其设定一个僵化的标准,而应当结合当时的环境,综合同意主体的年龄和心智来判断。在监护人代为行使同意权时,应当以患者的最大法益为考量的大前提,若家属意思与患者相违背,应以患者意思为准。患者的决定应当包括接受或是拒绝两方面,同意的内容是医疗行为及其结果。作出同意的方式有明示、默示和推定三种,同意可以在整个医疗行为的任意时间作出。当存在认识错误或是欺骗胁迫等情形时,患者的同意依然无法取得法律上的效果。在第四部分,笔者对缺少患者同意的医疗行为进行了考察,在无需病患同意的强制性医疗行为、无法获取病患同意的紧急医疗行为、患者放弃同意权及患者滥用权利的情况下,即便医疗行为缺乏患者同意仍具有正当性,除此之外的专断医疗行为,则需要根据不同的情况进行规制。在第五部分中,笔者对专断治疗行为的刑事立法提出了自己的建议,希望能通过宽缓的主刑以及多种附加刑对专断治疗行为起到一个良好的规制效果。
[Abstract]:The autonomy of every actor is the embodiment of their dignity. People have the right to choose what they want to be. This paper discusses the criminal law of patient's consent from the angle of preventing the illegality of medical behavior. The article is divided into five parts, mainly taking the patient's consent right in the medical behavior as the main line, and then discusses the concept of the medical behavior, the justification basis, the relation between the informed consent and the self-decision right, and the constituent elements of the patient's consent. Lack of patient consent, medical behavior, etc. In the first part, by defining the connotation and extension of medical behavior, the author comes to the conclusion that medical behavior is aggressive, which leads to the analysis of the legitimacy of medical behavior, and divides medical behavior into treatment behavior and other medical behavior. The author thinks that the consent of the patient is the core of the illegality of blocking the treatment behavior. When judging the legitimacy of other medical actions, we should grasp many elements. In the second part of the article, the author explains the philosophical basis of the right to self-decision, and holds that the principle of informed consent is a kind of self-decision in the field of medical treatment. The third part is the discussion of effective patients' consent. In the aspect of consent ability, the author argues that the consent subject should be judged by the age and mind of the consent subject, instead of setting a rigid standard for the consent subject. When the guardian exercises the right of consent on behalf of the guardian, the maximum legal benefit of the patient should be taken as the premise, and if the family member's intention is contrary to the patient's intention, the patient's will shall prevail. The patient's decision should include both acceptance and rejection, and consent is medical behavior and its outcome. Consent is given in three ways, express, implied and presumptive. Consent may be given at any time throughout the medical action. When there are cognitive errors or deception and coercion, the consent of the patient still cannot achieve legal effect. In the fourth part, the author investigates the medical behavior that lacks the patient's consent, under the circumstances of the compulsory medical behavior without the patient's consent, the emergency medical behavior which can not obtain the patient's consent, the patient's waiver of consent and the abuse of the patient's right. Even if the lack of patient consent is justified, the arbitrary medical behavior should be regulated according to different conditions. In the fifth part, the author puts forward his own suggestions on the criminal legislation of arbitrary treatment behavior, hoping to have a good regulatory effect on arbitrary treatment behavior through the main punishment of leniency and delay as well as various additional penalties.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：D924.1

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