Sirvent N, Bérard E
Service de Pédiatrie, CHU de Nice, Hôpital Archet 2, 151 Avenue de Saint Antoine Ginestière, Nice cedex 3, France.
Arch Pediatr. 2010 Feb;17 Suppl 1:S3-6. doi: 10.1016/S0929-693X(10)70002-6.
One aim of the law promulgated in France on March 4, 2002 concerning patients' rights and the quality of the health care system was to reconsider the bases of the physician-patient relationship. The new legal framework recommends establishment of a true dialogue between the two protagonists, and it assigns decisional priority to the patient rather than to the physician or third parties. In the case of minors, the principle of parental authority requires that the physician consults the holders of this authority before making any medical decision. However, the law of March 4, 2002 also reinforced the participation of minors in medical decisions concerning them. The lawmaker explicitly envisaged the possibility of overruling the principle of parental authority. This new "balance of power" obliges the physician to inform the minor of his or her medical condition in a manner appropriate to the child's degree of maturity. The minor may even put forward the principle of medical secrecy to prevent the sharing of information with his or her parents. This new "autonomy" of minors gives rise to at least two reservations: i) the difficulty involved in assessment of a minor's degree of discernment; ii) the minor's vulnerability with respect to his or her entourage.
2002年3月4日法国颁布的一项关于患者权利和医疗保健系统质量的法律，其目标之一是重新审视医患关系的基础。新的法律框架建议在医患双方之间建立真正的对话，并将决定权优先赋予患者而非医生或第三方。对于未成年人，父母权威原则要求医生在做出任何医疗决定之前咨询拥有该权威的人。然而，2002年3月4日的法律也加强了未成年人对涉己医疗决定的参与。立法者明确设想了推翻父母权威原则的可能性。这种新的“权力平衡”要求医生以适合儿童成熟程度的方式告知其病情。未成年人甚至可以提出医疗保密原则以防止信息被透露给其父母。未成年人这种新的“自主权”至少引发了两点保留意见：i）评估未成年人辨别能力程度存在困难；ii）未成年人相对于其周围人的脆弱性。
