精神康复中医疗告知履行时间——基于《精神卫生法》视角  

From the perspective of mental health law to see the implementation time of medical notice

作　　者：赵春海 吕江宁 赵姗姗 孙琦 Zhao Chunhai;Lv Jiangning;Zhao Shanshan;Sun Qi(Psychiatric diagnosis and treatment center,NO.984 Hospital of the PLA,Beijing 100094,China;Medical Department,the 980st Hospital of the PLA Joint Logistics Support Force,Shijiazhuang 050082,China)

机构地区：[1]联勤保障部队第九八四医院全军精神疾病诊治中心,北京100094 [2]联勤保障部队第九八○医院医务部,石家庄050082

出　　处：《卫生法学》2024年第4期59-64,共6页Health Law

基　　金：军队医学科技青年培育计划“军人精神障碍患者康复护理管理模式研究”(编号19QNP091)。

摘　　要：《精神卫生法》以“维护精神障碍患者的合法权益”为立法目的,体现了我国立法对精神障碍患者这个社会弱势群体合法权益需要特别保护的关注。作为精神障碍患者人身权的重要体现,其医疗自主权、住院期间的医疗知情同意权等权利的实现,均需要以能得到全面、适当并且通俗易懂的医疗信息为前提[1]。与此对应,医疗机构依法履行告知义务目的是保障患者的知情权,进而实现“自主权”“选择权”。时间不适当的告知对患者的自主权实现失去意义,超前的告知因其缺乏现实性、针对性而失去医学人文关怀价值,滞后的告知则因其对患者自主选择权缺乏指导意义而减损法律价值。《精神卫生法》有关告知条款的规定对医疗告知未做时间上的具体要求,是考虑临床实践是医学的不确定性和生命科学的未知性相互结合的过程,法律上如果明确具体时间可能造成立法目的与临床实践脱节而影响精神障碍患者权益的保障。因此,如何在临床实践中恰当而科学的履行告知义务,从而最大限度的保障患者知情权,就需要在深刻理解法律条款追求的立法宗旨基础上,与患者现实情况结合,选择和确定“合理”而“恰当”的时间和时机履行告知义务。The law stipulates that medical institutions perform the obligation of notification,the purpose is to protect the patients right to know,and then to achieve"autonomy"and"option".The accuracy and rationality of the content of medical notifications have revealed the medical value and humanistic care of the notifications;whether the notification time is appropriate determines whether the legal value can be realized.The wrong time notification has no significance for the realization of the patient's autonomy.The advance notification loses the value of medical humanistic care because of its lack of reality and pertinence.The lagging notification lacks the legal value because of its lack of guiding significance for the patient's autonomous choice.The legal provisions do not make specific require-ments on medical notification in terms of time,which is to consider that clinical practice is a process of combining the uncertainty of medicine and the unknown of life sciences;specific notification obligations need to be based on a deep understanding of the legislative purpose pursued by legal provisions Only when combined with the patients ac-tual situation can the"reasonable"and"appropriate"time be selected and determined.

关 键 词：告知 时间 精神障碍 精神卫生法 义务 

分 类 号：D902[政治法律—法学理论]