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[医学法律的最新进展]

[Recent developments in medical law].

作者信息

Schewe G

出版信息

Z Rechtsmed. 1984;91(3):165-83. doi: 10.1007/BF02116420.

Abstract

The most spectacular aspect is the extremely rapid expansion of medical law. Even if there is a close connection between developments in medicine and in law, the question must be asked as to what extent new discoveries and advances in medicine play a dominant role here, and to what extent the emphasis is on the further development of law. How advances in medicine can give rise to new legal problems was most impressively demonstrated some time ago by the discussion about cerebral death. In view of the progress made in the field of re-animation and intensive care, the current question is whether or not the physician's duties and rights to maintain life should be limited in hopeless cases when patients are incapable of making decisions themselves. This is demonstrated in particular by the discussion about the binding character of "patient testaments" in which healthy subjects declare that they do not want treatment under such circumstances. The decisive factor will continue to be the presumptive will of the patient at the respective time, and this will have to be ascertained considering all circumstances prevailing at that time. New questions with regard to the ethical and legal limitation of the technically feasible also arise from the possibility of culturing embryos from legal abortions or extracorporally fertilized ova to obtain transplants, and from the possibility of implanting extracorporally fertilized ova into the uterus, perhaps that of a "hired childbearing wet-nurse." In addition to ethical and legal problems, questions of parentage would arise here similar to those already of current interest in connection with artificial heterologous insemination. For physicians practicing these methods, questions concerning liability and the limitation of professional secrecy vis-à-vis the semen donor might become the issue of law suits in the near future. Current problems of "unsuccessful sterilization" and nonperformance of an abortion through the physician's fault although abortion was indicated for eugenic reasons are, on the other hand, primarily due to the fact that the law--possibility even for acceptable reasons--establishes legal obligations for the physician which, in the last analysis, aim at preventing human life from coming into being.(ABSTRACT TRUNCATED AT 400 WORDS)

摘要

最引人注目的方面是医疗法的极速扩张。即便医学发展与法律发展之间存在紧密联系,但仍需追问,医学上的新发现和进步在此发挥主导作用的程度如何,以及对法律进一步发展的强调程度又如何。不久前关于脑死亡的讨论,最为令人印象深刻地展示了医学进步如何引发新的法律问题。鉴于复苏和重症监护领域取得的进展,当前的问题是,在患者自身无法做出决定的无望情况下,医生维持生命的职责和权利是否应受到限制。这一点尤其体现在关于“患者遗嘱”的约束力的讨论中,健康受试者声明他们在这种情况下不希望接受治疗。决定性因素仍将是患者在相应时间的推定意愿,而这必须结合当时存在的所有情况来确定。从合法堕胎或体外受精的卵子中培育胚胎以获取移植器官的可能性,以及将体外受精的卵子植入子宫的可能性,或许还有“代孕产子”的可能性,也引发了关于技术可行性的伦理和法律限制的新问题。除了伦理和法律问题,这里还会出现与人工异源授精目前所引发的类似的亲子关系问题。对于实施这些方法的医生而言,与精液捐赠者相关的责任问题以及职业保密的限制问题,可能在不久的将来成为诉讼的焦点。另一方面,当前“绝育失败”以及因医生过错导致堕胎未成功的问题(尽管出于优生原因本应进行堕胎),主要是因为法律——即便出于可接受的原因——为医生设定了法律义务,归根结底这些义务旨在防止人类生命诞生。(摘要截取自400字)

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