Krukemeyer M G, Pflugmacher I, Möllenhoff G
Abteilung Radio-Onkologie, Paracelsus-Klinik Osnabrück, Am Natruper Holz 69, 49076 Osnabrück, Deutschland.
Zentralbl Chir. 2010 Feb;135(1):87-91. doi: 10.1055/s-0029-1224644.
The surgeon's duty to inform patients determines the indication to a therapeutic and/ or diagnostic procedure. Despite ongoing information made available by the professional associations, the complaints against surgeons providing treatment are on the increase. Only careful health education information with records kept of the course of treatment adopted will safeguard the doctor in charge from patients' claims for damages. Case law demands that the doctor put the patient in a position to understand what is happening to him or her and for him or her to be able to make a decision freely. The patient's compliance after being provided with health education information makes the corpus delicti of bodily harm void. A special form is the matter of fact of "transfer negligence", when the doctor and/ or the hospital is aware, prior to execution of the treatment, that treatment is not possible lege artis. What continues to be applicable to health education information is that the more urgent the operation, the less information is indicated, so that in emergencies such operation can be completely done without. Apart from general risks, such as wound infection and/or the danger of thrombosis, information must also be provided about special risks and the course of any follow-up treatment. Legal practice shows that simply handing over forms is not sufficient. The patient may forgo treatment. Aborting an operation for purposes of providing health information is balancing between the patient's interests in immediate execution of the indicated measure, on the one hand, and the right of self-determination on the other. Should the operation be able to be aborted without any serious consequences for the patient, then it is to be thus done.What does principally apply in civil litigation is the rule of the burden of proof.
外科医生向患者进行告知的义务决定了治疗性和/或诊断性程序的适应症。尽管专业协会不断提供相关信息,但针对实施治疗的外科医生的投诉仍在增加。只有提供细致的健康教育信息并记录所采用的治疗过程,才能使主治医生免受患者索赔损害的影响。判例法要求医生让患者能够理解自身的情况,并能够自由做出决定。在提供健康教育信息后患者的依从性会使身体伤害的犯罪事实无效。一种特殊情况是“转移过失”的事实,即医生和/或医院在实施治疗前就意识到按技术规范无法进行治疗。健康教育信息仍然适用的一点是,手术越紧急,所需告知的信息就越少,以至于在紧急情况下可以完全不进行此类告知。除了一般风险,如伤口感染和/或血栓形成的危险外,还必须告知特殊风险以及任何后续治疗的过程。法律实践表明,仅仅发放表格是不够的。患者可能会放弃治疗。为了提供健康信息而中止手术是在患者立即实施指定措施的利益与自决权之间进行权衡。如果手术能够中止且对患者没有任何严重后果,那么就应该这样做。在民事诉讼中主要适用的是举证责任规则。