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1.
通过对医疗告知及对患者知情同意权的尊重的重要性的讨论,重点叙述了医疗告知的内容和要求、法律责任,强调了要规范医疗告知行为,就要使医疗告知程序合法、告知方式合适、告知范围适度、告知内容完善、告知对象合适,最终使医患双方在诊疗过程中的各个环节做好沟通,相互理解,相互尊重,努力减少医疗纠纷。  相似文献   

2.
本文通过对2起替代医疗方案告知缺陷引起医疗纠纷的思考,针对当前医务人员对医疗风险认识不足、医患沟通不利、“替代医疗方案”告知缺陷等原因,导致医疗纠纷频发的情况,提出应增强医务人员的法律意识,尊重患者的知情选择权,规范医疗知情同意告知行为,对有效避免纠纷的发生具有现实意义。  相似文献   

3.
落实知情同意权的法律思考   总被引:6,自引:0,他引:6  
作者分析患者知情同意的法律基础及其法律责任,认为知情同意达到违法阻却必须满足以医疗为目的、充分履行告知义务和被告知者须有知情同意的能力等为条件。并就知情同意书免责条款的法律效力、医疗活动中的强制行为进行法律解析,认为提高医疗主体履行法定责任的自觉性才能自觉地实践告知义务,达到医院患者和谐。  相似文献   

4.
关玉梅 《卫生职业教育》2011,29(23):127-128
目的 通过对我院2009年7月至2010年6月住院患者入院知情告知书、委托书、手术知情告知书及其他告知书的执行情况进行检查分析,找出缺陷,及时防范医疗纠纷.方法 随机抽查全院24个临床科室843份现住患者病历并进行统计分析.结果 告知书中的住院知情告知书、委托书缺陷较大,具体是知情告知书内容不全、患者或委托人签名不规范.结论 临床医师要高度重视住院知情告知书内容、委托书填写及签名,杜绝因知情告知不到位而引发的医疗纠纷.  相似文献   

5.
患者知情同意权利越来越受到社会各界的重视,这其实也是对医生说明告知义务的履行提出了更高的要求.合格、有效的履行说明告知义务应是一个动态延续的过程,贯穿于医疗行为始终,特别是术中发生意外需要另行告知患者或患者家属的情况,容易被忽视、遗忘.本文通过分析一则与此方面有关的典型医疗纠纷案例,探讨医生术中说明告知义务履行的相关问题并对侵犯患者知情同意权的医疗侵权类型进行反思.  相似文献   

6.
何运昉  余小平  董燕 《西部医学》2007,19(5):978-979
目的探讨病人知情同意对医疗投诉的影响。方法回顾统计医院2003~2005年发生的医疗投诉、因知情同意告知不全的投诉例数;发生的医疗纠纷、因告知不全产生的纠纷的例数;使用自行设计的统一调查问卷,对本院住院病人96例为对象做知情同意整体抽样调查。结果2003~2005年医院发生医疗投诉112起,因知情同意告知不全发生的投诉27起(24.1%);医疗纠纷28起,因知情同意告知不全发生的纠纷17例(60.5%)。2006年4月医院知情同意调查的情况:患者对自己主管医生的知晓率为100.0%;主管护士知晓率为92.0%;对科主任的知晓率为90.0%;对护士长的知晓率为92.0%;对自己所患疾病的诊断、检查、用药、病重等告知知晓率为95.0%~96.0%;患者需做各种有创检查、有创治疗、输血、麻醉风险、手术风险的告知知晓率为100.0%。结论病人的知情同意权利受很多因素的影响。医务人员是告知病人和家属知情同意的主体。知情同意告知不全在医疗投诉和医疗纠纷中占较大的比例。目前,医院已重视了知情同意的告知程序,但在真正落实的过程中,还存在相当大的差距。病人知情同意的实现任重道远。  相似文献   

7.
关于医疗知情同意书使用现状的伦理学思考   总被引:1,自引:1,他引:0  
针对我国医疗知情同意书在内容、形式、告知程序中存在的一些问题,提出医疗知情同意书的使用建议:确保患者享有信息充分告知权、确保患者对信息的完全理解、确保患者对诊疗措施的自主选择、确保内容上符合伦理学与法律原则.  相似文献   

8.
目的随着我国法律制度的不断完善,病人法律知识的普及,知情同意逐渐被病人所重视,因临床告知而引发的医疗纠纷也在逐年增加.精神专科由于其服务对象的特殊性,重症病人发病时无自知力及行为能力,封闭管理病人住院期间无家属陪护,临床上在履行告知义务时增加了相应的难度.我院在医疗活动中履行告知义务时,在尊重病人基础上,通过强化医务人员法律意识、建立健全临床告知制度,加强医护人员自身诊疗、护理中的监督等措施,提高患者在护患、医患关系互动中的地位,最终达到了提高医疗、护理质量的目的,有效避免了因告知缺陷而引发的医疗纠纷的发生.  相似文献   

9.
近年来,医患纠纷呈上升趋势,究其原因,有相当一部分是由于病人和家属对医疗工作的特殊性、风险性和相关政策不了解,对诊疗过程不知情造成的.医院能否做好医患之间的沟通与医院医疗纠纷是否发生有密切关系.护患之间沟通的实质其实就是护士是否完整地履行告知义务,患者是否确实享受有了知情同意权.  相似文献   

10.
高风险病例管理是临床工作的重点,常涉及医疗风险、社会问题等诸多方面。医务社会工作以其专业理念和方法,参与高风险病例评估、讨论、诊疗风险告知等。介入高风险病例管理,促进医患沟通,改善患者就医感受,协助临床工作。因此培养医务社会工作专业人才,规范医务社会工作,建立有医务社会工作参与的医院风险管理体系,是加强高风险病例管理、有效防范医疗纠纷发生的又一新举措。  相似文献   

11.
Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P< 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P< 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.  相似文献   

12.
Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P < 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (>0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P <0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P < 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.  相似文献   

13.
Objective: To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods: SD rats served as both donors and recipients. 4℃ sodium lactate Ringer's was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava (IVC) inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results: Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion: This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.  相似文献   

14.
Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.  相似文献   

15.
Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.  相似文献   

16.
A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care(~'4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.  相似文献   

17.
Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.  相似文献   

18.
Journal of Nanjing Medical University (English Edition) JNMU, sponsored by Nanjing Medical University, was established in 1987. It is a bimonthly comprehensive English medical journal published locally and abroad.Since 2007, Journal of Nanjing Medical University (English Edition )was granted Elsevier the full publishing and distribution rights worldwide for the Electronic Edition, excluding the People's Republic of China.  相似文献   

19.
目的:评价使用安心颗粒对急诊经皮冠状动脉介入术(PPCI)术后生活质量的影响.方法:将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组(术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次)和对照组(仅接受基础药物治疗).所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表(MIDAS)、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果:入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异(P>0.05);出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低(P<0.05);组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低(P<0.05).两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血(P>0.05).两组发生轻度血小板减少症的患者数比较无差异(P>0.05).结论:PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.  相似文献   

20.
Objective To measure Derpl and Blot5 allergen levels in asthmatics' homes in Hongkong.Methods Seventy houses were enrolled for a mite indoor environment study. Dust samples were obtained from two sites of each patients' house: bed and floor. Derpl and Blot5 levels were quantified by a two-site monoclonal antibody-based ELISA technique.Results The levels of Derpl allergens found in bed (geometric mean (GM) 3.43 μg/g of dust; 95%CI, 1.89-4.96 μg/g)and on the floor (GM 1.12 μg/g of dust; 95%CI, 0.71-1.53 μg/g) indicated significant differences (P=0.005). However, the levels of Blot5 allergens found in bed (GM 19.00 μg/g of dust; 95%CI, 0.89-38.90 μg/g) and on the floor (GM 6.14 μg/g of dust; 95%CI, 0.40-11.90 μg/g) showed no statistically significant difference. In addition, in regards to the exposure index for Derpl and Blot5 allergens found in bed and on the floor, 17.6% in bed and 8.6% on the floor had levels of Blot5 ≥ 10 μg/g of dust, higher than those obtained for Derp1 (7.2% and 0% in bed and on the floor respectively, P< 0.05); higher percentages in bed and on the floor (25.0% and 35.7%) were observed for levels of Blot5 =0 μg/g of dust as compared with Derpl in bed and on the floor (4.3% and 14.5% respectively, P< 0.05).Conclusions Derpl and Blot5 are the major allergens found in this regional study, Blot5 is a more potent allergen in Hongkong, probably reflecting the high level of exposure to Blomia tropicalis (Bt). Bt and Dermatophagoides pteronyssinus (Dp) allergens should be included for precise diagnosis and effective immuno-therapeutic treatment of mite allergy in Hongkong.  相似文献   

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