本文選題：醫(yī)患關(guān)系 + 法律家長主義　； 參考：《吉林大學(xué)》2012年碩士論文

【摘要】：醫(yī)患關(guān)系中存在著一種醫(yī)療家長主義調(diào)整方式，存在于私人之間且從患者利益出發(fā)，而法律家長主義是一種由法律對行為人自由進(jìn)行合理干預(yù)的方式，這一干預(yù)方式應(yīng)用到醫(yī)患關(guān)系當(dāng)中去便有了其獨(dú)特的含義：基于患者的利益而對其進(jìn)行法律的干預(yù)。這種干預(yù)建立在尊重患者自主權(quán)利基礎(chǔ)之上，是一種適當(dāng)有限的干預(yù)，同時又對患者利益進(jìn)行風(fēng)險(xiǎn)預(yù)測的法律干預(yù)。醫(yī)患關(guān)系中的法律家長主義是一種審慎的合理干預(yù)方式。全文分為四個部分。 第一部分從醫(yī)學(xué)、醫(yī)患關(guān)系以及法律家長主義的概念特性來闡釋醫(yī)患關(guān)系中的法律家長主義不同之處。醫(yī)學(xué)領(lǐng)域由具有神秘色彩的巫醫(yī)巫術(shù)發(fā)展而來，是一門專業(yè)性很強(qiáng)的學(xué)科。醫(yī)學(xué)這一特性使得醫(yī)生因掌握技術(shù)而天然的處于強(qiáng)勢地位，也就有了傳統(tǒng)的家長制來對待處于弱勢地位的患者。而對于醫(yī)患關(guān)系有了“視患為親”倫理上的意義，也有了對于醫(yī)患關(guān)系進(jìn)行不斷的探討，研究醫(yī)患關(guān)系應(yīng)該適用什么樣的關(guān)系，包括縱向的不同學(xué)科和橫向即醫(yī)學(xué)內(nèi)部的醫(yī)患關(guān)系模式研究。法律家長主義運(yùn)用到醫(yī)患關(guān)系當(dāng)中正是由于對醫(yī)患關(guān)系不斷探索的結(jié)果。盡管法律家長主義在不同領(lǐng)域內(nèi)都是不同程度的干預(yù)，但是醫(yī)患關(guān)系中的法律家長主義具有其獨(dú)特之處：首先是對于私域的個人行為之間的調(diào)整；其次這種法律家長主義相對于原有醫(yī)療家長主義是一種適度謹(jǐn)慎的干預(yù)。醫(yī)患關(guān)系中的法律家長主義建立在尊重患者自主權(quán)基礎(chǔ)之上的理論，針對醫(yī)患關(guān)系的特性，法律家長主義具有更強(qiáng)的適用性。 第二部分從行為能力入手并結(jié)合案例對醫(yī)患關(guān)系中的法律家長主義進(jìn)行了類型分析。對于行為能力的認(rèn)定具有重要的意義，因?yàn)樾袨槟芰κ撬接虍?dāng)中個體自治的基礎(chǔ)，也是患者自主權(quán)的行使成為可能。不同的行為能力，法律家長主義也有不同程度與不同方式的干預(yù)。對于具有完全行為能力的患者而言，擁有更多自主的權(quán)利，但是并不意味著是完全的自主權(quán)，因?yàn)榛颊咴诩膊〉恼勰ブ�，在精神和心理上都會呈現(xiàn)弱勢的狀態(tài)，此時如果有患者自己做出決定，有可能會使醫(yī)生推托責(zé)任，也是患者難以達(dá)到真正的自主決定，因而在特定的條件下應(yīng)該允許法律為其利益而進(jìn)行的干預(yù)；對于無行為能力和限制行為能力人而言，患者本身不能夠做出自主的決定，而這種權(quán)利主要集中于其父母或者家屬以及其他代理人身上，其父母或者家屬在決定的權(quán)利上可能會受到其他因素的影響，此時在患者的利益可能會受到傷害的情況下，，法律家長主義有必要進(jìn)行適當(dāng)?shù)母深A(yù)，維護(hù)患者的最佳利益。本部分主要結(jié)合了因信仰拒絕輸血的案例，缺陷新生兒以及中國比較典型的肖志軍案件對法律家長主義干預(yù)進(jìn)行了分析并對不同行為能力的患者干預(yù)范圍進(jìn)行了歸納。 第三部分探討了醫(yī)患關(guān)系中法律家長主義適用的標(biāo)準(zhǔn)。主要從三個標(biāo)準(zhǔn)進(jìn)行分析：第一是法律“引導(dǎo)式”干預(yù)。這點(diǎn)闡述的是建立在尊重患者自主權(quán)和知情同意權(quán)基礎(chǔ)上，將傳統(tǒng)的醫(yī)療家長主義轉(zhuǎn)變?yōu)橐环N引導(dǎo)式的干預(yù)，即醫(yī)生在同患者商議的前提下，對于一些適合患者治療方案和方法進(jìn)行建議和引領(lǐng)，使得患者得到最佳狀態(tài)的治療；第二是法律干預(yù)應(yīng)符合適當(dāng)比例的原則。比例原則是行政法中重要的原則，核心詞強(qiáng)調(diào)的適當(dāng)、適度，這一點(diǎn)同樣可以應(yīng)用到醫(yī)患關(guān)系中。法律家長主義干預(yù)手段應(yīng)基于患者利益為目的，其干預(yù)所帶來的利益應(yīng)超過其所帶來的損害；第三是法律對于醫(yī)療中風(fēng)險(xiǎn)的預(yù)測與規(guī)避。這里要求在遇有緊急情況時，法律對于這種風(fēng)險(xiǎn)應(yīng)進(jìn)行準(zhǔn)確的預(yù)測，并積極的幫助患者規(guī)避風(fēng)險(xiǎn)，這是醫(yī)患關(guān)系中法律家長主義的最終目的和干預(yù)的合法依據(jù)。 第四部分是對全文的梳理與總結(jié)。
[Abstract]:There is a way of adjusting medical paternalism in the relationship between doctors and patients. It exists between the private and the interests of the patients. The legal paternalism is a way of rational intervention by the law to the freedom of the perpetrator. This intervention has its unique meaning: Based on the interests of the patient. The intervention based on the law, which is based on respect for the rights of the patient, is an appropriate and limited intervention and a legal intervention for the risk prediction of the interests of the patient. The legal paternalism in the doctor-patient relationship is a prudent and reasonable intervention. The full text is divided into four parts.
The first part explains the differences in the legal paternalism in the doctor-patient relationship from the concept of medicine, doctor-patient relationship and legal paternalism. The medical field is developed from the mystical witch witchcraft. It is a highly specialized subject. The characteristic of medicine makes the doctor strong in mastering the technology. There is a traditional patriarchal system to treat patients in a disadvantaged position, and the relationship between doctors and patients is ethical and the relationship between doctors and patients is continuously discussed, and what kind of relationship should be applied to the relationship between doctors and patients, including the relationship between the longitudinal different subjects and the medical relationship within the medicine. Pattern study. The application of legal paternalism to the doctor-patient relationship is the result of the continuous exploration of the relationship between doctors and patients. Although the legal paternalism intervened in different fields in different fields, the legal paternalism in the doctor-patient relationship has its unique features: first, the adjustment of personal behavior between the private areas; Secondly, the legal paternalism is a moderate and prudent intervention relative to the original medical paternalism. The legal paternalism in the doctor-patient relationship is based on the theory of respecting the autonomy of the patient. In view of the characteristics of the doctor-patient relationship, the legal paternalism has a stronger applicability.
The second part makes a type analysis of the legal paternalism in the doctor-patient relationship from the behavior ability and combined with the case. It is of great significance to the identification of the behavior ability, because the behavior ability is the basis of individual autonomy in the private domain, and the exercise of the patient's autonomy is possible. Different behavioral abilities and legal paternalism also There are different degrees and different ways of intervention. For patients with complete behavior, there is more autonomy, but it does not mean that it is complete autonomy, because the patient is mentally and mentally disadvantaged under the suffering of the disease, and if a patient makes a decision, it may make it possible to make a decision. The doctor's responsibility is also difficult for a patient to achieve a genuine autonomous decision, so that the law should be allowed to intervene in the interests of the law under certain conditions; for those who are not able to do so, the patient itself cannot make an autonomous decision, and this right is mainly concentrated on their parents or their families and their own. On his agent, his parents or family members may be affected by other factors in the right to decide. At this time, when the interests of the patient may be hurt, the legal paternalism is necessary to intervene properly to maintain the best interests of the patient. This part should be combined with a case of refusing a blood transfusion by faith and a new defect. The children and the typical Xiao Zhijun case in China have analyzed the legal paternalism intervention and summarized the scope of the intervention for the patients with different behavior abilities.
The third part discusses the standard of the application of the legal paternalism in the doctor-patient relationship. The first is the analysis of the three standards: first, the "guiding" intervention of the law. This is an exposition of the transformation of traditional medical paternalism into a guide type on the basis of respecting the rights of the patient and the right to informed consent, that is, the doctor is in the same way. On the premise of patient consultation, some suggestions and guidance are made for the treatment scheme and method suitable for patients to make the patient get the best state of treatment; the second is the principle that the legal intervention should conform to the appropriate proportion. The principle of proportion is the important principle in the administrative law, the core word emphasizes appropriate and moderate, which can also be applied to the doctor and patient. In the relationship, the means of legal paternalism should be based on the interests of the patient, and the benefit of the intervention should exceed the damage it brings; third is the law's prediction and avoidance of the risk in the medical treatment. Risk avoidance is the legal basis for the ultimate purpose of legal paternalism and intervention in the doctor-patient relationship.
The fourth part is the carding and summary of the full text.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：D909.2

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 尹田;自然人的行為能力、意思能力、責(zé)任能力辨析[J];河南省政法管理干部學(xué)院學(xué)報(bào);2001年06期

2 包聰會;生永保;;洛克自由定義的解讀及其辯證性分析[J];銅仁學(xué)院學(xué)報(bào);2011年02期

3 呂建高;;病人自主權(quán)的倫理與法理[J];環(huán)球法律評論;2010年06期

4 韓冬;;緊急避險(xiǎn)制度在急�；颊哚t(yī)療知情同意中的應(yīng)用研究[J];中國衛(wèi)生法制;2009年04期

5 王然;;“風(fēng)險(xiǎn)社會理論”對知情同意制度完善的若干啟示[J];中國衛(wèi)生法制;2009年05期

6 關(guān)立云;;論我國知情同意權(quán)代為行使主體的法律規(guī)制——“丈夫拒簽字致妻兒死亡事件”的法律審視[J];皖西學(xué)院學(xué)報(bào);2008年03期

7 王一多;論“自由”與“意志自由”——關(guān)于“理性”與“意志自由”問題[J];西南民族學(xué)院學(xué)報(bào)(哲學(xué)社會科學(xué)版);2000年08期

8 楊芳,潘榮華;病人知情同意權(quán)的幾個辯證法問題[J];醫(yī)學(xué)與社會;2001年04期

9 陸于宏;張金鐘;;“放棄”或“救治”沖擊道德底線——關(guān)于有缺陷新生兒救治問題的倫理思考[J];醫(yī)學(xué)與哲學(xué)(臨床決策論壇版);2008年11期

10 邱仁宗;;有缺陷新生兒的處理和倫理學(xué)[J];醫(yī)學(xué)與哲學(xué);1986年05期

相關(guān)碩士學(xué)位論文 前1條

1 邱翔;有限醫(yī)療家長主義及其辯護(hù)[D];湖南師范大學(xué);2008年

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