Lekári poučujú prvýkrát často deň pred operáciou | Medicínske právo
              

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Lekári poučujú prvýkrát často deň pred operáciou


 | 15.10.2011 | komentárov: 297

Uvádzame článok z nemeckého portálu WELT ONLINE,v ktorom sa autor podrobnejšie venuje náležitostiam povinnosti lekárov poučiť pacientov pred tým než podstúpia operačný zákrok.

Obrazok Zo striktne právneho hľadiska je operácia ublížením na tele. Z tohto dôvodu musí pacient udeliť súhlas. Odborníci objasňujú povinnosti lekára.

Je to jeden z termínov, ktoré skutočne nikto nemá rád, a to operácia. Aj keď je väčšina pacientov značne nervózna alebo práve preto, mala by využiť poučenie lekára pred chirurgickým zákrokom na zodpovedanie otázok a odstránenie prípadných starostí.
 
Poučenie (Aufklärungsgespräch)  má  – ako už prezrádza názov– objasňovať. "Rozhodujúce pritom nie je, či pacient obdrží formulár, v ktorom je všetko vysvetlené, ale to, či sa mu naozaj poskytne poučenie",  tvrdí  Ekkehart Schäfer, právnik špecializujúci sa na medicínske právo a viceprezident spolkovej právnickej komory v Berlíne. Pacient má právo na sebaurčenie a môže preto rozhodnúť, či a akým spôsobom chce byť liečený. "Zásah lekára do tela pacienta, teda obzvlášť operácia, je v právnom slova zmysle ublížením na tele", tvrdí odborník. Ublíženie na tele je trestné, preto musí mať lekár právne zdôvodnenie na zákrok, a to súhlas pacienta. Aby pacient súhlas udelil, musí pochopiteľne vedieť a rozumieť tomu, s čím súhlasí.

Lekár má ako odborník, čo sa znalostí týka, oproti pacientovi výhodu. Situáciu musí dostatočne vysvetliť tak, aby pacient rozumel, zdôrazňuje Holger Zenk, poradca pre pacientov v spolkovej správe - Nezávisle poradenstvo pre pacientov – UPD, Berlin. To neznamená odborné (pre laika ťažko zrozumiteľné), ale dobre pochopiteľné vysvetlenie prípadne poskytnutie tlmočníka, ak má pacient jazykové ťažkosti. Ak pacient niečomu nerozumie, nemal by sa hanbiť pýtať sa. Okrem iného musia byť pri poučení zdôraznené rozličné skutočnosti, ako tvrdí Andreas Waltering z inštitútu Kvality a Efektivity v zdravotníctve (IQWiG), Kolín:
Pacient musí byť oboznámený s tým, čo sa stane, ak sa nepodrobí zákroku. Taktiež: "Lekár nemôže len povedať,  'Nemáte na výber', musí povedať,'Existujú aj iné možné alternatívy'."

Samozrejme,  pacient musí byť  oboznámený aj s možnými rizikami. Pritom musia byť spomenuté  všeobecne platné riziká, hoci sú len nepatrné, a taktiež špecifiká zákroku, zdôrazňuje Waltering. To znamená:"Informácia o hojení rán po zákroku je rovnako dôležitá, snáď len ako uvedienie minimálneho rizika, ktoré môže pacient pocítíť."

Dĺžka rozhovoru závisí od druhu zákroku. Kladenie otázok je právom pacienta. Odpovedať na ne je povinnosťou lekára. Takýto dialóg medzi pacientom a lekárom môže trvať celkovo 30 minút alebo skoro dve hodiny. Dôležité je, aby dĺžka  rozhovoru  postačovala na objasnenie otázok, zdôrazňuje Waltering.  Poučenie sa dáva často deň pred operáciou, je v kompetencii lekára a nie zdravotnej sestry, tvrdí Waltering. Spravidla postupuje pacient pred veľkou operáciou takýto rozhovor dvakrát: jeden s anesteziológom, ktorý mu vysvetlí podrobnosti týkajúce sa narkózy, druhý s chirurgom, ktorý môže objasniť odborné skutočnosti.
 
Ak  si pacient želá, aby pri danom rozhovore bola prítomná aj druhá osoba (napr. niekto z príbuzných), je to jeho právo, tvrdi Zenk. Avšak, lekár má povinnosť mlčanlivosti a musí sa postarať aj  o to, aby ostatní pacienti  vo viaclôžkových izbách nenačúvali a nezisťovali osobné veci."  V takomto prípade je vhodnejšia izba lekára, kam si možno vziať druhú osobu."

Základom rozhovoru je často štandardizovaný formulár s údajmi o príslušnej operácii. Ak sú pacientovi vysvetlené všetky otázky, formulár na konci rozhovoru podpíše. "Tým vyhlási, že súhlasí so zákrokom“, tvrdí Schäfer.
Odborník z Nezávisleho  poradenstva pre pacientov – Zenk radí, aby si pacient jeden z týchto hárkov ponechal. "Môže si ešte raz prečítať určité veci týkajúce sa zákroku."Ak dôjde k zmene, alebo ak sa dohodli na veci nad rámec formulára a zaznačili to na papier, je možné vyžiadať si kópiu takéhoto formulára. "


AUTOR: Aliki Nassoufis
ZDROJOVÝ TEXT: Nassoufis, A:  Ärzte klären oft erst am Tag vor der OP auf, WELT ONLINE, 01.09. 2011
OBRÁZOK: ubbmc.buffalo.edu
PREKLAD:  Lucia Onderková




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