RESEARCH PAPER
Legal grounds for ‘extending the scope or type of procedure’
| 1 | Department of Medical Law of the Medical University of Lodz, Faculty of Management of Social Academy of Sciences, Lodz, Poland |
| 2 | Department of General and Colorectal Surgery of the Medical University of Lodz, Poland |
| 3 | Division of Clinical Toxicology, Nofer Institute of Occupational Medicine, Lodz, Poland |
| 4 | Chair of Economical Informatics, University of Lodz, Faculty of Public Health, Medical University of Lodz, Poland |
Ann Agric Environ Med 2017;24(4):606–609
KEYWORDS:
extending the scope of operative fieldinformed consentinformed refusallegality of operationwithdrawal from healthservice provision
ABSTRACT:
Introduction:
The development of patient rights and increasing number of lawsuits based on medical malpractice make medical doctors constantly improve knowledge regarding the acceptability of changing the scope of operation. This is particularly important when patients have expressed their refusal to changing the scope and type of procedure (ESTP) or no informed consent (IC) has been obtained from the patient prior to the procedure.
Material and Methods:
The method of study comprised content analysis of existing legislation. The current jurisprudence and doctrine were confronted with existing regulations. An algorithm of correct formal procedures was elaborated.
Results:
The doctor has right to realize ESTP when the patient has not given the consent to it or the refusal expressed by him was not fully conscious. Healthcare providers are absolutely prohibited from realizing ESTP when patient objected to any changes being thoroughly informed by the physician prior to the operation. When patient refuses possible ESTP, the doctor has the right to withdraw from performing surgery but should inform the patient about other places, where a similar procedure can be provided.
The development of patient rights and increasing number of lawsuits based on medical malpractice make medical doctors constantly improve knowledge regarding the acceptability of changing the scope of operation. This is particularly important when patients have expressed their refusal to changing the scope and type of procedure (ESTP) or no informed consent (IC) has been obtained from the patient prior to the procedure.
Material and Methods:
The method of study comprised content analysis of existing legislation. The current jurisprudence and doctrine were confronted with existing regulations. An algorithm of correct formal procedures was elaborated.
Results:
The doctor has right to realize ESTP when the patient has not given the consent to it or the refusal expressed by him was not fully conscious. Healthcare providers are absolutely prohibited from realizing ESTP when patient objected to any changes being thoroughly informed by the physician prior to the operation. When patient refuses possible ESTP, the doctor has the right to withdraw from performing surgery but should inform the patient about other places, where a similar procedure can be provided.
CORRESPONDING AUTHOR:
Radosław Zajdel
Chair of Economical Informatics, University of Lodz, Faculty of Public Health, Medical University of Lodz, Poland
REFERENCES (28):
| 1. | Schaefer C, Kirschning S. Informed decisions: patient and consumer information at the German Agency for Quality in Medicine (ÄZQ), Z Evid Fortbild Qual Gesundhwes. 2010;104(7): 578–84. doi: 10.1016/j.zefq.2010.09.001. Epub 2010 Oct 18. |
| 2. | Zajdel J, Zajdel R, Dziki A, Wallner G. Alcohol-intoxicated patients at admission room – analysis of legal aspects of rendered medical services, Ann Agric Environ Med. 2012; 19(4): 701–706. |
| 3. | Filar M. Postępowanie lecznicze (świadczenie zdrowotne) w stosunku do pacjenta niezdolnego do wyrażenia zgody. 1/2003 (13 Vol. 5). |
| 4. | Boratyńska M. Wolny Wybór. Gwarancje i granice prawa pacjenta do samodecydowania, Warszawa 2012 r., pp. 311–328. |
| 5. | Sośniak M. Odpowiedzialność cywilna lekarza, Warszawa 1968. |
| 6. | Nesterowicz M. Zabiegi lekarskie w świetle orzecz nictwa SN. Palestra 1976; 1: 31. |
| 7. | Zajdel J, Zajdel R, Krakowiak A. Should a doctor stop rendering medical services? Principles of conduct towards patients attempting to commit suicide. Part 1 -- the Polish perspective. Ann Agric Environ Med. 2013; 20(1): 155–60. |
| 8. | The Medical Profession Act 5.12.1996, tj. DzU 2011 r., nr 277, poz. 1634, ze zm. |
| 9. | The Act on Patient Rights 6.11.2008,tj. DzU 2012 r., nr 159. |
| 10. | Faden RR, Beauchamp LT. A history and theory of informed consent. Oxford 1986. |
| 11. | Niemczyk S, Łazarska A. Materialnoprawne elementy aktu zgody pacjenta w ujęciu prawnym i medycznym. PiM. 2005; Nr 2 (19, vol. 7). |
| 12. | Rouanne M, Lebret T. Patient information and professional responsibility: reversal of jurisprudence of the Court of cassation, Prog Urol. 2012; 22(1): 67–9. doi: 10.1016/j.purol.2011.04.001. Epub 2011 May 17. |
| 13. | Rougé-Maillart C, Tuech JJ, Pessaux P, Riche P, Penneau M. Patient information: management in the beginning of the XXIth century, Presse Med. 2001; 30(2): 68–72. |
| 14. | Arndt M. Physician’s errors-legal advise for physicians accused of malpractice, MMW Fortschr Med. 2004; 146(5): 25–6, 28–9. |
| 15. | Wyrok SN z 25.09.1969 r., II CR 353/69, OSP 1970, poz. 116. |
| 16. | Goodare H, Smith R. The rights of patient of research (editorial, comment). BMJ 1995: 310: 1277–1278. |
| 17. | Deber RB. Physicians in health care management: The patient physician partnership. Changing roles and the desire for information. Can Med Assoc J. 1994; 151(2): 171–176. |
| 18. | Savatier R. Traite de la responsabilite civile, wyd. 2. (1951), r. II. |
| 19. | Wyrok SN z 29.12.1969 r., sygn., II CR 551/69, OSPiKA 1971 r., z. 6, poz. 118. |
| 20. | Art. 26§1 Ustawy kodeks karny z 6.06.1997 r. |
| 21. | Wyrok SN z 27.11.2007 r., sygn., V KK 81/07, OSNKW 2008/2/14, Biul.SN 2008/2/19. |
| 22. | Zoll A. Stan wyższej konieczności jako okoliczność wyłączająca przestępność czynu w praktyce lekarskiej, PiM 2/2005 (19, vol. 7). |
| 23. | Dukiet-Nagórska T. Stan wyższej konieczności w działalności lekarskiej, PiM. 2005; 2 (19, vol. 7). |
| 24. | Wyrok SA w Katowicach, sygn. I ACa 34/08, PS 2011; nr 4:144. |
| 25. | Chmielewska U, Ciołkowski S, Wiwatowski T. Praktyka leczenia Świadków Jehowy bez krwi – aspekty medyczne, prawne i etyczne. Teza 1. PiM. 2003; 13: 83. |
| 26. | Wyrok SN z 27.10.2005 r., sygn., III CK 155/05, OSNC 2006/7–8/137, Biul. SN 2006/2/9. |
| 27. | Śliwka M. Prawa pacjenta w prawie polskim i porównawczym. Toruń 2008. |
| 28. | Art. 23 Ustawy Kodeks cywilny z 23 kwietnia 1964 r. |
Related articles
