Study On Present Situation Of Informed Consent And Strategy In View Of New Medical Reform Policy

BackgroundPresent, hospitals as the operators have weak awareness of risk and consciousness in safeguarding their legal rights, while, patients as the consumers lay claim to better care and rights. In recent years, doctor-patient relationship is more intensive, and unavoidably caused many medical tangles which were difficult to resolve. Doctor-patient relationship which is not simple medical questions anymore, has become social problem.Even though " General Principles of the Civil Law of the People’s Republic of China" and " The Regulation on the Handling of Medical Accidents" both have stated clearly that medical disputes could be worked out by negotiation, but this negotiation has become private settlements gradually that fomented many medical disputes and influenced the normal processing of medical disputes. Medical personnel are being forced to take defensive medical behavior.In the face of an increasingly tense relationship and the contradictions between doctors and patients, the implementation of the patients’ medical informed consent is one way to lessen medical disputes as well as the continuous improvement of the construction of legal system. Purpose(1)To understand the doctor-patient relationship after New Medical Reform Policy.(2)Analyzing the recent three years typical medical disputes and investigating patients’ and their families’ cognitive, attitudes, opinions and advice through random sampling of Guangzhou A hospital and studying the present situation of informed consent.(3)Analyzing the reason of patients’ and their families’ dissatisfaction with informed consent.(4) Discusses how to strengthen medical informing for the hospital to reduce medical disputes and alleviate the doctor-patient relationship.significanceAll doctors hope to cure their patients, however, because of individual differences, the high risk and uncertainty in medical practice, treatment effects may not be satisfied, or even cause patients to die. Some patients or their families that can’t accept the bad endings would act aggressively in some ways against hospitals and the medical workers. These behaviors not only make the hospital and medical workers suffer the huge economic losses, but also seriously disturb the normal medical working order and cause extremely psychological shadow to the medical workers.There are few researches on how to strengthen medical informing for the hospital and medical staff to reduce the medical disputes and alleviate the doctor-patient relationship, as well as a lot of researches on patients’ right of informed consent from the legal and ethical perspective which is in order to protect the rights of patients and studies on medical staff’s duty of informing have been done.We try to fulfill the duty of caring and informing in order to reduce the related risk and disputes as far as possible in the reasonable and legitimate case. We try to create a pleasant environment for the medical worker and maintain the interests of the hospital and the medical workers and build the harmonious doctor-patient relationship, as well as implementing the patients’ right of informed consent.MethodsUnder the frame of history research methodologies, literature review, document analysis, case review, interviews etc. are adopted as data collection and to build the relationship between the qualitative data and the concept, which are mostly qualitative research. The quantitative analysis of statistical data also was used. Now stated below:Archival. This article is based on researches of doctor-patient relationship. informed consent and medical staffs informing obligation whose data from CNKI. Science Direct. Pub Med. VIP-database. Chinainfo. relative laws and regulations and data from the Web site of Ministry of Health of the People’s Republic of China, the Web site of the Health Department of Guangdong province, the Web site of China Medical Association etc., then concludes the situation of doctor-patient relationship after New Medical Reform Policy and informed consent.Documentary analysis. This article involved documents includes the documents issued by Department of health, documents, work summary and meeting minutes of Guangzhou A Hospital.Retrospective case studies.23severe medical disputes of2009to2011were analyzed, and9of them were founded that had faults in medical informing. The thesis tried to detail the nine cases and find the existing problems.Semi-structured interview. This survey is a cross-sectional investigative study. The questionnaire based on documents and research purpose was designed. Because people who have professional medical education have better comprehensive ability than those who haven’t, which will influence the satisfaction of hospital workers’ informing consent, people who have professional medical education were excluded. Investigators talked with each patient, explained the purposes, contents and procedure of this survey, and asked their permission. In order to get all respondents’true ideas and ensure the interview results, all respondents were told that this interview was anonymous and won’t impact the follow-up treatment.100outpatients and100hospitalized patients of Guangzhou A Hospital are randomly selected. Investigators dispelled their doubts neutrally and made it easy to understand, then recorded the interview data.Research ideasAccording to the researches on doctor-patient relationship and the informed consent right by predecessors, and the background of new medical health reform, this article collected and explained the current situation of doctor-patient relationship, the concept of informed consent, the history of informed consent, and current situation of informed consent. To learn about current situation of informed consent systematically and comprehensively, a large number of documents analysis, empirical analysis of the typical cases and case interviews of Guangzhou A hospital, have been studied. The relationships of medical informing and medical disputes has been analyzed. Last but not least, some measures combined with the existence value, ethics value and institutional framework, about how to regulate the doctors’ manners and medical informing behavior were studied in order to reduce medical disputes.Conclusion(1)The new medical health reform is come close. There are some achievements, however, some problems are still severe. Research has suggested that patients are mostly not satisfied with the medical costs and accessibility rather than doctors and nurses. Because medical workers have to contact with patients directly, this evolves conflicts between doctors and patients. The doctor-patient relationship is still tense, and has a deteriorating trend. The number of medical damage compensation disputes has increased year by year. and its complexity and importance have been brought to the forefront. There is still a lot of work for us to do to construct a harmonious doctor-patient relationship.(2)The typical informed consent theory based on legal culture, medical ethics, and medical management model comes from Western. If we introduce it into China’s medical practice, we should consider its adaptability to laws, traditional culture, and the doctor-patient relationship.(3) There were23severe medical disputes including medical informing defects in Guangzhou A Hospital from2009to2011and9of them involved informing defects. The exiting medical informing defects included:no informing, part informing, nonstandard informing, not signed the informed consent form. For example, some doctors didn’t inform surgery complications and announcements, or changed the operation method in the process of operation without patients’ permission, or misrepresent, or use non-standard expression during informing; preoperative conversation was carried through by other people; some doctors didn’t inform drug side-effects and so on. Medical disputes brought big troubles to medical institutions and medical workers, and also caused the huge economic losses.(4) The author interviewed200patients (or their families) randomly in Guangzhou A hospital, in order to learn about the patients’ opinions on the work of hospital informed consent and suggestions. Results:13people thought that the hospital failed to fulfill any inform obligation, and ask patients to take exams and tests or medicine without any explanation and3of them thought that medical workers didn’t inform on purpose.91people thought the hospital told that not all, for example, some medical staff did not fully informed them of patients’ conditions and precautions or the reason of taking a treatment, efficacy, and the existing risk, whether there were any alternative treatment and benefit analysis, the reasons and the costs of checks, risk ratio, probable risk, the side effects of drug treatment, what side effects could be, the price of drug treatment and so on.11people thought hospital workers existed the phenomenon of induced informing, for example, some medical workers deliberately exaggerated illness so that he could earn more money from patients’ treatment, such as doctors’costly prescription; or recommend strongly some treatment to their patients just because they were good at this treatment or for the good of scientific research, even though they know it is not the best treatment, or exaggerated the goodness of some treatment.98people thought that medical workers’ terms were too professional to understand.95people thought that medical workers didn’t spend enough time and patience in explaining the standard phrase of medical and communicating with patients.28people reflected that some medical workers merely made perfunctory attempts to inform and had a bad attitude, considering none of patients’ feeling. All of the patients (or their families) declared that if hospital didn’t carry out obligations of medical informing and caused any bad result, they would reserve their right.(5) At present, the situation of doctor-patient relationship in our country is still tough. It is not enough to ensure that medical informing was really carried out, just depend on medical workers’self-discipline. Hospitals should strengthen medical ethics education for medical workers and enhance the medical workers" informing consciousness. Hospitals should make a standardization and humanized informed consent forms, as well as standardize the medical workers’ informing behavior. Hospitals should improve the medical workers’ skills of informing and establish the medical inspection and supervision mechanism of informing. Hospitals should also improve patient’s medical knowledge. In order to reduce unnecessary medical disputes and litigation, the hospital should really protect patients’ rights. So that our entire medical environment could develop healthily.