From June 5438 to/kloc-0 to October 6, 2003, Xiaomou was initially diagnosed as intragastric basal myoma by a hospital, and there were no other symptoms. Three days later, the hospital performed a myomectomy on the small stomach. After the operation, the doctor informed Xiao's family that the patient's spleen had been removed. The family asked the reason, and the surgeon told them that it was because the myoma of the stomach was closely adhered to the spleen, and the separation operation was very difficult. Forced separation may damage the arteries and veins at the entrance of spleen; Splenectomy is much lighter than the possible massive bleeding and life-threatening consequences of patients, so resection measures have to be taken to achieve the purpose of surgery. Xiaomou and his family believe that the hospital removed the spleen without telling and obtaining its consent, which caused Xiaomou to lose part of his stomach and spleen. After the operation, Xiaomou's body immunity decreased obviously, and he often had a cold and headache and lost his ability to work. Therefore, I filed a civil lawsuit with the court for compensation.
"trial"
This case is a doctor-patient dispute caused by not respecting the patient's right to know. The court held that the defendant hospital had to remove the non-pathological spleen in order to avoid the patient's life danger, and failed to fulfill the obligation of informing and fully respect the patient's right to know, thus depriving the patient of the right to choose the surgical plan. There was a fault according to law and he should be liable for damages.
"analysis"
It is a special service contract between equal subjects that patients go to the hospital for medical treatment. The establishment of the contract is marked by the completion of patient registration. Honesty and credit is the basic principle to maintain an equal and harmonious doctor-patient relationship, which requires patients to actively cooperate with doctors, and doctors should also respect patients' right to know. The State Council's Regulations on Handling Medical Accidents also clearly stipulates that patients' right to know should be respected. For example, it is stipulated that medical institutions and their medical staff should truthfully inform patients of their illness, medical measures and medical risks, and answer their consultations in time; Patients have the right to consult, copy and duplicate medical records. At the same time, for those who fail to truthfully inform patients of their illness, medical measures and medical risks, or refuse to provide patients with the service of copying or duplicating medical records without justifiable reasons, the legal responsibilities that they should bear are clearly stipulated. It can be seen that the failure to tell the patient truthfully is one of the legal situations to confirm that the doctor is at fault and bear the responsibility.
Patients' right to know comes from citizens' right to life and health endowed by law. The so-called right to life and health includes the right of natural persons to control their lives and their physical and physiological functions without illegal interference from others. Specifically, it mainly includes the natural person's right to protect his own life, maintain and pursue health, and provide blood, body and organs for others, as well as the right to ask the infringer to compensate for property losses or ask the judicial organ to investigate the infringer's legal responsibility when he is sick or his rights are infringed. In China, it is clearly stipulated that the parties have the right to know that the Consumer Protection Law. The law stipulates that "consumers have the right to know the real situation of the goods they buy or use or the services they receive." At the same time, it is stipulated that "consumers have the right to choose their own goods or services." In the case of disputes between doctors and patients, the right to know in medical treatment means that patients have the right to know their own medical information, such as their illness, treatment measures, medical risks, medical expenses, doctors' basic information, technical level and so on. If these rights are punished by others without their knowledge, regardless of whether the perpetrator is in good faith or malicious, his behavior constitutes infringement and he should bear legal responsibility.
The patient's right to know is a right derived from the principle of human life and health rights and the freedom of right allocation. This right should include three basic contents: first, the right to know the real condition, that is, patients have the right to know the real situation and development trend of their own diseases; The second is the right to know about treatment measures, that is, patients have the right to choose the treatment plan and treatment measures that doctors plan to take in order to avoid or reduce medical risks; The third is the right to know medical expenses, that is, patients have the right to know the amount, purpose and expenditure progress of various medical expenses they should bear for medical treatment. Because human organs and their functions are generally non-renewable, once lost, they no longer exist, and the corresponding physiological functions will also be affected, which will last until the end of the patient's life. Patients will take greater risks than ordinary consumers and should be given more rights. Therefore, what makes the right to know become a one-time right is the patient's right to choose, that is, the patient has the right to choose the examination method and treatment measures independently and agree or disagree with the operation, examination or treatment plan on the basis of knowing his own condition and medical risks. It is meaningless for patients who have no choice to know.
The exercise of patients' right to know and choose must rely on medical advice, otherwise, as patients without medical professional skills, they can only be in a disadvantageous position of "being trampled upon by others", and the equal subject relationship between doctors and patients will become castles in the air. Therefore, patients' right to know and choice is opposite to doctors' obligation to inform, which is a legal obligation based on the principle of good faith in civil activities. According to the law and trial practice, the essential content of the medical party's obligation to inform should include four aspects: (1) Informing the patient's condition. Truthfully inform patients of the name, present situation, degree, development trend and possible health-threatening consequences of the disease; However, for the sake of goodwill to prevent the rapid deterioration of the disease and avoid possible or inevitable adverse consequences to the patient, the delay in informing the patient himself is an exception. (2) Handling the notification. Truthfully inform the patient of the treatment plan for the disease, the measures to be taken and the preventive measures to avoid danger. When surgical treatment is taken, it shall be signed and agreed by the patient and his family. (3) Risk notification. Truthfully inform the possible or inevitable dangers, or the treatment measures for other harmful consequences such as allergy, rejection, deterioration and complications that may occur due to the patient's specific physique. (4) Notice of expenses. Truthfully inform patients of the expenses they should bear for treating diseases and their billing basis.
Of course, the system of informing patients is far more than these four contents. From the perspective of perfecting the notification system, it should also include auxiliary contents to ensure patients to exercise their right to know. On the one hand, the institutional notification rules. Such as outpatient service, first aid, hospitalization, discharge or critical and difficult cases, the time of death of patients, etc. If the format text cannot be clearly informed, the competent physician shall make a transcript of the conversation. The content, time and method of informing patients strictly follow the corresponding regulations. On the other hand, it is to inform the basic situation of medical skills. In a certain form, the basic situation of the hospital, technical equipment, medical staff titles, medical specialties, management rules and regulations, patient rights, charging standards, etc. will be publicized or informed to patients. So that patients can exercise their right to seek medical treatment.
Judging from the medical behavior characteristics of the doctor in this case, the patient Xiaomou was diagnosed as gastric basal myoma with no other symptoms. Failing to fulfill the obligation of informing Xiao and his family, and surgically removing the spleen without finding any lesions is obviously a fault of treatment behavior and should be liable for damages according to law.