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阿根廷的晚期患者与拒绝医疗的权利

Terminal Patients and the Right to Refuse Medical Treatment in Argentina.

作者信息

Hevia Martín, Schnidrig Daniela

机构信息

Executive Dean at the School of Law of Universidad Torcuato Di Tella, Buenos Aires, Argentina.

Project Coordinator at Global Partners Digital, London.

出版信息

Health Hum Rights. 2016 Dec;18(2):247-250.

Abstract

The right to health has many dimensions. On the one hand, it entails positive duties for states to protect the health of individuals. On the other, it encompasses patient decision making regarding personal health, an idea which is closely linked to the right to autonomy and the right to free development of the individual-that is, to dignity. This is why the informed consent of the patient and her right to make a choice according to her own values should be honored, even when her decision may seem irrational or imprudent. When patients are incapable of providing informed consent-for example, if the patient is unconscious-the law can authorize certain persons to act as a proxy on their behalf. In Argentina, the Patients' Rights Act (2009) as amended by the Death with Dignity Act (2012) states that if a patient is unable to provide informed consent, consent may be provided on her behalf by her close relatives, affinal kin, or legal guardian, in this order of preference. The Patients' Rights Act also permits patients to set up advance directives regarding health decisions to be made if they become terminally ill. In 2015, the Argentine Supreme Court of Justice discussed the scope of patient autonomy in the case . This case presented a question that had yet to be explored by the court: how can we determine an unconscious patient's will if she does not have written advance directives concerning whether a life-sustaining medical treatment should be continued? This article examines the grounds of the Argentine Supreme Court's decision in First, we describe the case law that existed prior to Then, after explaining the facts of the case, we discuss the ruling and raise doubts about its scope..

摘要

健康权具有多个层面。一方面,它要求国家承担保护个人健康的积极义务。另一方面,它涵盖了患者对个人健康的决策,这一理念与自主权以及个人自由发展权(即尊严权)紧密相连。这就是为什么即使患者的决定看似不合理或不谨慎,也应尊重其知情同意权以及根据自身价值观做出选择的权利。当患者无法提供知情同意时,例如患者失去意识,法律可授权某些人代表他们做出决定。在阿根廷,经《尊严死亡法》(2012年)修订的《患者权利法》(2009年)规定,如果患者无法提供知情同意,可由其近亲、姻亲或法定监护人按此优先顺序代表她提供同意。《患者权利法》还允许患者就身患绝症时的健康决策制定预先指示。2015年,阿根廷最高法院在该案件中讨论了患者自主权的范围。该案件提出了一个法院尚未探讨的问题:如果一名失去意识的患者没有关于是否应继续维持生命的医疗治疗的书面预先指示,我们如何确定她的意愿?本文审视了阿根廷最高法院在该案件中的判决依据。首先,我们描述了之前存在的判例法。然后,在解释案件事实之后,我们讨论了该裁决并对其范围提出质疑。

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