医療と自己決定権

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  • イリョウ ト ジコ ケッテイケン
  • Medical Care and Patients' Rights to Self-Determination

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Abstract

There has been much controversy surrounding the need for medical professionals to obtain consent from patients before administering medical treatment, and the responsibility for medical professionals to adequately inform patients of the treatment they plan to administer, as well as patients' right to refuse life-saving treatment. This paper, which discusses a Jehovah's Witness' refusal of a blood transfusion, does not focus on patients' refusal of medical treatment per se , but cases involving the specific refusal of blood transfusions as a method of medical treatment. This case focuses on an emergency blood transfusion performed in a trauma case. The patient in question was treated at a teaching hospital by a team of three doctors. The doctors—believing the patient's life to be at risk— administered a blood transfusion without first obtaining the patient's consent. It can be said that it is a physician's responsibility, or even duty, to make saving patients' lives the number one priority. This puts physicians in the position of having to explain to their patients the need for accepting a blood transfusion, and to do whatever they can to convince their patients to do so. The main point at issue in this court case revolves around the contention that the patient did not want a blood transfusion because it went against their religious beliefs. Despite this fact, the physician performed the blood transfusion without the patient's approval, and was thus negligent in their responsibility to provide the patient with the necessary information required to make an informed decision. In the end, it was determined that it was against the law to deny the patient the right to choose how the surgery was to be performed. One implication resulting from this case is whether Article 13 of the Japanese constitution—specifically, the right to the pursuit of happiness—includes protection against violations of the right to self-determination, and whether the right to self-determination includes the right to freedom of religious beliefs and practices. However, the final judgment did not specifically address whether the Japanese constitutional provisions have any bearing on this case. Furthermore, the patient in this case was a minor , which raises questions as to the ability to provide consent in this case.

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