Government and Policy

Family consent for vital surgery axed

By Zhang Yuchen (China Daily)
Updated: 2010-02-06 09:07
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Hospital laws amended in bid to save more patients' lives

The Ministry of Health has ordered medical institutions to drop the requirement for patients' family members to sign the informed consent in a bid to facilitate emergency operations.

In line with the Fundamental Norms for Patients Case Recording, to take effect on March 1, medical institution officials in charge or authorized officials will have the right to sign the informed consent to save the patient's life in an emergency.

The statutory representative should sign the informed consent when the patient loses the capacity to act for himself, the norms said.

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The medical institution officials in charge or authorized officials are entitled to sign the informed consent if a severely injured person is brought to hospital in an unconscious state and if anyone on behalf of the patient is unavailable to give informed consent, according to the norms.

"It is good to some extent to rescue patients' lives within the framework of the regulated medical procedure," said Zheng Shanhai, a doctor in the Intensive Care Unit (ICU) in China Meitan General Hospital.

"But it's better to further detail the norms."

Sometimes the patient's family has trouble understanding the professional, complex informed consent issues, and the three to five minutes may delay the timely surgery, Zheng said.

The practice of seeking family members to sign the informed consent before an operation has been widely blamed for delays in life-saving surgeries.

Li Liyun, a 22-year-old migrant woman who was in her ninth month of pregnancy, died of serious pneumonia at Jingxi Hospital in western Beijing on Nov 21, 2007 as her husband refused to sign the informed consent to let doctors perform Caesarean surgery.

Her death raised controversy over whether the hospital should have performed surgery without her husband's permission, given her condition.

Approximately 65 percent of 12,000 respondents to an online poll at voted to support the change, saying it will help in the timely treatment of patients. However, about 22 percent of them doubt the change, saying it may invade the patient's family's right to be informed.

The 38-article norms posted on the website of the Ministry of Health also requires the recording of complete information on the patients' case history once they are admitted to a hospital.

It stipulates that the medical record should be written in Chinese and foreign languages and only universal abbreviations can be used.

If a doctor is making a correction to a patient's record, he or she should draw two lines on the wrong character to make sure the original record remains clear and legible, and sign his or her name and the date every time they correct anything.

The doctor is not allowed to wipe out the original record by scratching out, or by pasting or gluing another paper on top.

The licensed hospital officials check, approve and sign any records written by the houseman or the would-be doctor in his probationary period, the norms said.

A patient's record being generated on a computer should be typed and printed and signed manually, it said.

The correction is allowed in the process of typing or printing in accordance with limits of authority.

Any manually signed record, however, may not be modified.