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Judgments on medical malpractice related to accountability in anesthesia and the related departments

麻醉及相关科室相关医疗事故责任认定

基本信息

批准号：
17591626
负责人：
NOSAKA Shuichi
金额：
$ 2.37万
依托单位：
Shiga University of Medical Science
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2005
资助国家：
日本
起止时间：
2005 至 2007
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-17591626/
关键词：
anesthesia medical malpractice precedent explanation

项目摘要

We investigated the recent judicial precedents on malpractice related to accountability in anesthesia and the related departments. Precedents were reported in Japanese legal journals published before 2004. Not only the general explanation, but also explaining to individual patient is required according to the precedents. Lost cases due to violations of the explanation duty have increased. A reasonable patient decision concept was conventionally adopted. However, recently there have been some judicial precedents adopting the concrete patient theory. We made the written information sheets about anesthesia. In these sheets, the risks of anesthesia were shown and the frequencies of complications of anesthesia were shown in exact figures but in some complications the frequencies were shown ambiguously due to absence of reports. The information sheets prepared in France and Germany emphasized the uncertainty of anesthesia. No medical procedure is completely free of risks. In these sheets, most of complications were shown but with regard to frequency, some complications were not shown in exact figures. There are clearly no judicial answer to the clinical judgments of what information should be given to the patient. Anesthesiologists need to provide patient-specific information required for informed consent. With regard to the important role of anesthesia within the surgical process, providing written information outlining risks and benefits of anesthesia is acceptable, important and useful in obtaining informed consent from patient. Explanation of the risks to patient before anesthesia is a good way to prevent severe problems such as law suits.

本文对近年来麻醉及相关科室发生的医疗事故责任追究司法判例进行了调查。2004年以前出版的日本法律的期刊中报道了这一先例。不仅要做一般性的解释，还要根据先例对个别患者进行解释。因违反说明义务而败诉的案件有所增加。一个合理的病人决定的概念，传统上采用。然而，近年来也有一些司法判例采纳了具体受事说。我们制作了关于麻醉的书面信息表。在这些表格中，显示了麻醉的风险，并以精确的数字显示了麻醉并发症的频率，但由于缺乏报告，某些并发症的频率显示不明确。在法国和德国编写的信息表强调了麻醉的不确定性。没有一种医疗程序是完全没有风险的。在这些表中，显示了大多数并发症，但就频率而言，有些并发症没有以准确的数字显示。对于应该向患者提供哪些信息的临床判断，显然没有司法答案。麻醉师需要提供知情同意所需的患者特定信息。关于麻醉在手术过程中的重要作用，提供概述麻醉风险和受益的书面信息是可以接受的，对于获得患者知情同意书是重要和有用的。麻醉前向患者解释风险是防止严重问题（如法律诉讼）的好方法。