Until the evening of September 5, the "maternal fall incident in Yulin No. 1 Hospital of Shaanxi Province" that occurred on August 31 was still confusing. Is it because the hospital does not agree to a cesarean section? Or did the family never sign, causing the mother to fall from the building in unbearable pain? The hospital and family members still have different opinions.

So, does a cesarean section require a signature from family members? Are there any relevant regulations to clarify this? Are the implementation standards consistent across locations? In addition, what should we do if the hospital requires both parties to sign, but the opinions of the mother and her family members are not consistent?

Some obstetricians and gynecologists and lawyers said in interviews that there is actually no legal basis for requiring family members to sign for cesarean section operations, but the common situation is that "both the mother and her family members need to sign and agree." Why is this?

Lawyer’s opinion:

Pregnant women have the right to decide whether to have a natural birth and cesarean section without the signature of their family members

As for the maternal fall incident, according to Yulin First Hospital According to the report, the mother’s family members have always refused to sign and agree to a cesarean section. So, does a cesarean section really require the signature of the mother’s family to consent? In this regard, lawyer Zhong Lanan from Beijing Jingshi Law Firm gave a negative answer.

“As a pregnant woman, of course she has the right to decide whether to give birth naturally.” Zhong Lan’an believes that in accordance with Article 55 of my country’s Tort Liability Law, medical staff should explain the condition and medical measures to patients during diagnosis and treatment activities. . If surgery, special examination, or special treatment is required, the medical risks, alternative medical plans, etc. should be explained to the patient in a timely manner and their written consent should be obtained; if it is not appropriate to explain to the patient, the patient should be explained to the patient's close relatives and their written consent should be obtained. .

Doctor’s point of view:

Gynecology and obstetrics expert Gong Xiaoming questions why the power of family members exceeds that of the mother herself

“Why does the power of family members exceed that of the mother? They are all 18 years old For adults, the husband cannot make decisions for the mother." Gong Xiaoming, a well-known expert in obstetrics and gynecology in my country and deputy chief physician of the Department of Obstetrics and Gynecology of Union Medical College, also questioned the practice of Yulin First Hospital.

Industry attempts:

Hangzhou Obstetrics and Gynecology Hospital allows women to sign to decide whether to have a cesarean section

In fact, not all medical institutions require cesarean section Both the mother and her family must sign before the uterine delivery operation. For example, Hangzhou Obstetrics and Gynecology Hospital in Zhejiang Province, provided that the indications for cesarean section are met, the mother can sign by herself to decide whether to have the surgery, and the signature of the mother's family members is not required.

An obstetrician and gynecologist at the hospital who wished to remain anonymous said that people with independent civil capacity as stipulated by law can decide to sign on their own. There is a medical situation where if the patient is under 18 years old, or suffers from mental illness such as Alzheimer's disease, cannot independently exercise civil rights, or needs to undergo general anesthesia surgery, the patient cannot exercise his rights during the surgery. In this case, the patient needs Entrusting family members to exercise their right to choose medical measures requires their signature. However, medical staff must also explain to patients and their families what may happen during the operation in advance.

“But some surgeries, such as termination of pregnancy within marriage, require both spouses to sign in order to reduce medical disputes. For example, sterilization surgeries also require both spouses to sign, in order to reduce unnecessary disputes. Legally There is no such regulation, everyone has the right to dispose of their own body,” said the above-mentioned doctor.

Hospital Current Situation:

It is a common phenomenon that both parties are required to sign before a cesarean section

It is a common phenomenon that the hospital requires the signature of both the mother and her family members before the cesarean section. . The reporter consulted a number of obstetricians and gynecologists working in different medical institutions, and the answers they received were that "both the mother and her family members need to sign and agree."

An obstetrician and gynecologist at a tertiary hospital told reporters that as early as 2009, the former Ministry of Health promulgated and implemented the "Regulations on the Management of Medical Institutions", of which Article 33 stipulated: "Medical institutions perform surgeries, special procedures When conducting examinations or special treatments, the patient’s consent must be obtained, and the consent and signature of his family members or related persons must be obtained.”

“This rule has not changed since the regulations were implemented. Therefore, we require that cesarean section must be signed by both the mother and her family,” said the obstetrician and gynecologist.

Question:

What should I do if both parties are required to sign but the mother and her family members disagree?

If both parties are required to sign, it is assumed that the family members and the mother have different opinions. Not unified, what should I do? The doctor said that this situation has rarely been encountered so far.

However, lawyer Zhong Lanan put forward his own opinions on this. He pointed out that the effectiveness of laws is higher than regulations. Compared with the "Regulations on the Management of Medical Institutions", the "Tort Liability Law" is also a newer law, and of course the provisions of the "Tort Liability Law" apply.

As an adult, the mother has the full right to know and the right to decide her own treatment plan when she is conscious. Even if the mother has signed the informed consent form, she can change her mind at any time and decide the treatment plan by herself while she is awake. "The problem lies in the unique doctor-patient relationship. Once a medical problem occurs, many family members will resort to the hospital to solve the problem instead of going to court. This will lead to the fact that what doctors and hospitals have to deal with is not the mother. I am a family member of the mother.

This creates a strange cycle of patients’ informed consent choices: when choosing medical actions, the patient’s opinion is not important, but the family’s opinion is important.

”