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强制披露基于良知的医疗实践限制

MANDATING DISCLOSURE OF CONSCIENCE-BASED LIMITATIONS ON MEDICAL PRACTICE.

作者信息

Sawicki Nadia N

出版信息

Am J Law Med. 2016;42(1):85-128. doi: 10.1177/0098858816644717.

Abstract

Stakeholders in law, medicine, and religion are unable to reach consensus about how best to address conflicts between healthcare providers' conscientious objections to treatment and patients' rights to access medical care. Conscience laws that protect objecting providers and institutions from liability are criticized as too broad by patient advocates and as too narrow by defenders of religious freedom. This Article posits that some of the tension between these stakeholders could be mitigated by statutory recognition of a duty on the part of healthcare institutions or providers to disclose conscientiously motivated limitations on practice. While this solution would not guarantee a patient's access to treatment, referral, or information from any given provider, it would prevent some of the more egregious cases of denial of treatment--those where patients are not made aware that a legal and clinically defensible treatment option is excluded from a provider's or institution's scope of practice and so have no opportunity to seek care elsewhere.

摘要

法律、医学和宗教领域的利益相关者无法就如何最好地解决医疗服务提供者基于良心拒绝对治疗的反对意见与患者获得医疗护理的权利之间的冲突达成共识。保护提出反对意见的医疗服务提供者和机构免于承担责任的良心法,受到患者权益倡导者的批评,认为其过于宽泛,同时也受到宗教自由捍卫者的批评,认为其过于狭隘。本文认为,通过法律认可医疗机构或医疗服务提供者有义务披露基于良心动机的执业限制,这些利益相关者之间的一些紧张关系可以得到缓解。虽然这种解决方案不能保证患者从任何特定的医疗服务提供者那里获得治疗、转诊或信息,但它可以防止一些更为恶劣的拒绝治疗情况——即患者没有被告知某种合法且临床上合理的治疗选择被排除在医疗服务提供者或机构的执业范围之外,因此没有机会在其他地方寻求治疗。

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