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医生是否应该停止提供医疗服务?第二部分——波兰视角下未成年人知情同意存在不确定性的案例中的法医学行为分析。

Should a doctor stop rendering medical services? Part II - Analysis of medico-legal conduct in cases of uncertainties regarding informed consent in minors. The Polish perspective.

作者信息

Zajdel Justyna, Zajdel Radoslaw

机构信息

Department of Medical Law, Chair of Humanities, Medical University, Łódź, Poland.

Department of Medical Informatics and Statistics, Faculty of Health Sciences, Medical University, Łódź, Poland.

出版信息

Ann Agric Environ Med. 2014;21(2):388-93. doi: 10.5604/1232-1966.1108610.

Abstract

INTRODUCTION

The doctor's decision whether to save the life of a minor who has attempted to commit suicide depends on the decision of the person who, under legal regulations, is responsible for the minor. In everyday medical practice doctors are often placed in difficult situations and often cannot make any decision. Such doubts arise when it is impossible to contact the person(s) responsible for the minor. The doctor encounters similar issues when the parents of a minor under 16 years of age express different opinions on the recommended procedures, and are against the doctor's decision and do not want their child to be hospitalized.

MATERIALS AND METHODS

The current legislation and doctrine was analyzed and an attempt was made to determine the way of conduct with regard to suicidal minors, and algorithmize the way of conduct towards such suicidal minors. The conduct was discussed on the two examples, based on real clinical cases.

RESULTS

With regard to minors in a clinical state demanding urgent procedures, who have of the decision made by the guardian, and regardless of the fact there is no contact with the guardian. If the status is stable, the physician's modus operandi depends on various accompanying circumstances. However, he is still obliged to provide medical help.

DISCUSSION

A practical algorithm is presented and all the possible legal variations discussed and clarified.

摘要

引言

医生对于挽救企图自杀的未成年人生命的决定,取决于法律法规规定的对该未成年人负有责任的人的决定。在日常医疗实践中,医生常常面临困境,往往无法做出任何决定。当无法联系到对未成年人负有责任的人时,就会出现此类疑问。当16岁以下未成年人的父母对推荐的治疗程序表达不同意见、反对医生的决定且不希望其孩子住院时,医生也会遇到类似问题。

材料与方法

分析了现行立法和学说,并试图确定针对自杀未成年人的行为方式,并将针对此类自杀未成年人的行为方式进行算法化。基于真实临床案例,通过两个例子对行为方式进行了讨论。

结果

对于处于需要紧急治疗临床状态的未成年人,无论监护人是否做出决定,也无论是否与监护人取得联系。如果状态稳定,医生的操作方式取决于各种伴随情况。然而,他仍然有义务提供医疗帮助。

讨论

提出了一个实用的算法,并对所有可能的法律变化进行了讨论和阐明。

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[The origin of informed consent].[知情同意的起源]
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[Legally effective consent with minors and incompetent patients].
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Parents, adolescents, and consent for research participation.父母、青少年与研究参与同意书
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