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id="i2i2jyu4k" class="site fr"><a href='/'>首页</a>><a href='/yl/'>要论</a>><a href='/yl/rp/'>锐评</a></span> <span id="i2i2jyu4k" class="t" id="a1"><a href="/yl/rp/">锐评</a></span> </h1> <div id="i2i2jyu4k" class="pa_0_5_0_10"> <h1 class="Content_title" id="hh"> <span id="a" style="">一张难产死亡证明背后的信任?；?/span> </h1> <script>/*jQuery('#hh').width(jQuery('#a').width());*/</script> <div id="i2i2jyu4k" class="Remark"> <span>2016年07月28日 10:54 | 作者:堂吉伟德 | 来源：<a target="_blank">光明网</a></span> <span id="i2i2jyu4k" class="fr"> <div id="i2i2jyu4k" class="jiathis_style_24x24"> <a class="jiathis_button_qzone"></a> <a class="jiathis_button_tsina"></a> <a class="jiathis_button_tqq"></a> <a class="jiathis_button_weixin"></a> <a class="jiathis_button_renren"></a> <a class="jiathis jiathis_txt jtico jtico_jiathis" target="_blank"></a> </div> <script type="text/javascript" src="http://v3.jiathis.com/code_mini/jia.js?uid=1399539302485450" charset="utf-8"></script> </span><span id="i2i2jyu4k" class="fr">分享到：<img src="http://www.rmzxb.com.cn/images/fx.jpg" /> </span> </div> <div id="i2i2jyu4k" class="text_box"> <p align="center"> <p style="text-indent: 2em; text-align: left;">7月19日中午，朝阳区酒仙桥附近某公司一男员工忽然在卫生间晕倒，被同事送往医院后抢救，最终被医院诊断为猝死。但医院、社区均称无法为其出具死亡证明，死者陈尸太平间一个星期不能火化?；颊呒沂粢约盎乓皆悍矫姹硎?，朝阳警方已介入此事。（7月27日《新京报》）</p><p style="text-indent: 2em; text-align: left;">对于死亡证明的主体责任单位，以及院前院后死亡的办理程序，《国家卫生计生委公安部民政部关于进一步规范人口死亡医学证明和信息登记管理工作的通知》等文件作出了明确的规定。如果医院实施了抢救后死亡，应该是救治医院开；如果是在送医之前死亡的，应由死亡时所在片区的派出所、社区医院、救治医院人员同时在场的情况下，对死者的死因进行认定，无异议后，由社区医院开具死亡证明。</p><p style="text-indent: 2em; text-align: left;">此案的争议在于，尽管病人送来时已经死亡，但在患者同事的要求下，华信医院对病人实施了救治，符合相关“救治原则”中的主体责任，因而应当开具死亡证明。不过，按照北京市卫计委相关人员的解释，如果救治医院能够证明病人是在进入医院前就死亡，那么就应由社区医院来证明。其出具的“考虑院前死亡”，又与“完全认定院前死亡”有一定的概念上的差异，相关服务中心对此并不认可。一张死亡证明难产，逼得家属只能走尸检这一关键环节。</p><p style="text-indent: 2em; text-align: left;">按理说，基于人道主义的考虑，无论是救治医院，还是社区服务中心，都可以“特事特办”给予解决。然而问题在于，怕承担责任的心态，使得他们又不得不谨慎行事。从救治医院医生说可以开具证明，到后来的态度急转，表明这种情况在医院看来，属于可开可不开的范畴。毕竟医院实施了救治，只不过是在救治前死亡而已。在这种情况下，依据相关程序性规定，自然就会“能推就推”，能不开的就会选择拒绝开具。</p><p style="text-indent: 2em; text-align: left;">表面上看，这绝对是一种责任担当不够的表现，也是相关规定模糊下，导致的责任不清的体现。不过其背后的原因，则跟近年来医患关系紧张之下，院方怕承担责任有很大的关系。道理很简单，如果依据相关规定，如果由院方出具有死亡证明，也就意味着其实施了救治，跟院前死亡的事实有很大的差异。在这种情况下，若是死者家属据此向院方提出赔偿申诉，索取赔偿甚至大闹医院，这绝对是他们难以承受之重。按程序本可推脱的程序，本着多一事不如少一事，自然就不会主动替患者开具，并且在出具院前死亡证明，在表述上也采取了“考虑院前死亡”的模糊表达。</p><p style="text-indent: 2em; text-align: left;">从律师的解释上来看，难产的死亡证明显然应由实施救治的医院来开，不过其依然利用各种理由而进行推脱。院方的这种投鼠忌器的行为，固然应受到谴责。然而造成其“不作为”的原因更值得探析。在时下，医患关系日益紧张，彼此之间缺乏互信，尤其是患者动不动就对医生拳脚相加，一出现死亡事件就归咎于“医疗事故”，轻者纠缠不清，重则设灵堂，砸设备，打医生，破坏正常的医疗秩序。在息事宁人的心态下，不少医院又为此承受了不小损失，对各种不确定因素的恐惧，才导致了院方的“能不为则不为”的心态。</p><p style="text-indent: 2em; text-align: left;">这种状况就跟讹诈导致的“见扶不扶”一样，群体的信任危机，造成了人人自危和群体自伤的局面，从而形成了社会性的冷漠。跌倒者，只有在作出“自己摔倒，不怪别人”的承诺，并且有各种证明之后，才会得到救助。那么，一纸医院证明，难道也要患者家属作出“自己死亡，与医院无关”的承诺之后，医院才能开具死亡证明吗？猝死而寻求一张证明，最后还得走尸检的终极出路，这与其说是程序的严谨科学，不如说是信任危机之下个体的不信。只是处于这种环境下的每个人，都注定会成为“难产的下一个”。（堂吉伟德）</p><p><br style="text-indent: 2em; text-align: left;"/></p> </div> <p class="Editor">编辑：刘文俊 </p> <div id="i2i2jyu4k" class="Paging"> </div> <p class="Keyword">关键词：猝死死亡证明 </p> <h1 class="pv_title_2 mt_15"><a target="_blank" class="more mtb_14">更多</a><span id="i2i2jyu4k" class="t" id="a3"><a ><img src="http://www.rmzxb.com.cn/images/xg_t1.jpg" /></a></span></h1> <div id="i2i2jyu4k" class="pa_0_5_0_10"> <ul class="Related_ul bh_150"> <li><a target="_blank" href="/c/2016-07-14/917497.shtml">合成艳照敲诈到底骗到了谁</a></li> <li><a target="_blank" href="/c/2016-07-15/917493.shtml">急救拒抬病人不是医德问题</a></li> <li><a target="_blank" href="/c/2016-07-15/917483.shtml">会议费调整，关注标准不如监督落实</a></li> <li><a target="_blank" href="/c/2016-07-14/917474.shtml">120不抬病人，折射急救多少无奈</a></li> 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