RESEARCH PAPER
Alcohol-intoxicated patients at admission room – analysis of legal aspects of rendered medical services
 
More details
Hide details
1
Department of Medical Law, Chair of Humanities, Medical University, Lodz, Poland
 
2
Department of Medical Informatics and Statistics, Faculty of Health Sciences, Medical University, Lodz, Poland
 
3
Department of General and Colorectal Surgery, Medical University, Lodz, Poland
 
4
II Chair and Department of General Surgery, Gastroenterological and Alimentary Oncological Surgery, Medical University, Lublin, Poland
 
 
Ann Agric Environ Med. 2012;19(4):701-706
 
KEYWORDS
ABSTRACT
Current legal regulations do not explicitly state whether the doctor should or should not ignore the patient’s refusal to be provided with medical services when such refusal is given by the patients who is temporarily unable to take conscious decisions. The fact that there is no clear jurisdiction over the issue makes the relation between doctor and patient legally complicated. The doctor has no doubts whether he/she should or should not initiate the medical procedure when the patient clearly expresses the declaration of will, in which either refusal or consent is given to be provided with medical care. However, the patient remaining under the influence of alcohol, i.e. a substance which to some or great extent impairs cognitive functions, rational thinking, and the ability to evaluate incoming information. Alcohol makes the patient unable to interpret the information given by the doctor. Thus, the patient’s consent or refusal to be provided with medical care is lacking in the needed elements of “informing” and “conscious declaration of will”, which are considered by doctors and lawyers to be absolutely necessary to make such will valid. There are no clear, unambiguous regulations explaining how the doctor should behave in such cases. The authors of the presented study state that it is highly important to determine whether the intoxicated patient is able to understand the incoming information, evaluate it, make a conscious decision and finally, express an explicit (and therefore binding) refusal to accept recommended medical services. In the opinion of the authors, while dealing with such patients, the doctor should bear in mind the patient’s right to make autonomous decisions, but that it is also the doctor’s duty to provide the patient with medical services.
REFERENCES (23)
1.
Ustawa o zawodach lekarza i lekarza dentysty z dnia 5.12.1996r., tj. DzU 2011 r., nr 277, poz. 1634. (The Act on the Professions of a Medical Doctor and a Dentist, Act of 2011, Pub. L. No. 277, Stat. 1634 – December 5, 1996) (in Polish).
 
2.
Malone D, Friedman T. Drunken patients in the general hospital: their care and management. Postgrad Med J. 2005 Mar; 81(953): 161-6.
 
3.
Ustawa o prawach pacjenta i Rzeczniku Praw Pacjenta z dnia 6.11.2008r., DzU 2009r., nr 52, poz. 417, ze zm. (The Act on a Patient’s Right and a Patient’s Rights Spokesman, Act of 2009, Pub. L. No. 52, Stat. 417 – November 6, 2008) (in Polish).
 
4.
Ustawa o działalności leczniczej z dnia 15.04.2011r., DzU 2011r., nr 112, poz. 654 (¬e Act on Medical Activity, Act of 2011, Pub. L. No. 112, Stat. 654 – April 15, 2011) (in Polish).
 
5.
Ustawa o wychowaniu w trzeźwości i przeciwdziałaniu alkoholizmowi z dnia 26.10.1982r., tj. DzU 2007r., nr 70, poz. 473, ze zm. (The Act on Sober Upbringing and Counteracting Alcoholism, Act of 2007, Pub. L. No. 70, Stat. 473 – October 26, 1982) (in Polish).
 
6.
Pionkowski J, Wojdytawska I, Patura E. Pathological alcohol intoxication. Psychiatr Pol. 1975 Mar-Apr; 09(2): 161-6.
 
7.
Judgment of Supreme Court, 10.03.1998 r., No. I CKN 571/97, OSNC 1998r., No. 10, Stat. 170. (in Polish).
 
8.
Judgment of Court of Appeal in Warsaw, 31.03.2006 r., I ACa 973/05, Apel.-W-wa 2007/2/12. (in Polish).
 
9.
Safjan M. Kilka refleksji wokół problematyki zadośćuczynienia pieniężnego z tytułu szkody wyrządzonej pacjentom (Some Considerations on Money Compensation of Patients’ Damages). PiM 2005; 1: 18. (in Polish).
 
10.
Ustawa o zapobieganiu oraz zwalczaniu zakażeń i chorób zakaźnych u ludzi, z dnia 5.12.2008r., DzU 2008r., nr 243, poz. 1570 (Act on Prevention and Combating Infections and Infectious Diseases, Act of 2008, Pub. L. No. 243, Stat. 1570 – December 5, 2008); Ustawa Kodeks karny wykonawczy z dnia 6.06.1997r., DzU 1997r., nr 90, poz. 557(Act on Penal Code Executive, Act of 1997, Pub. L. No. 90, Stat. 557 – June 6, 1997); Ustawa o ochronie zdrowia psychicznego z dnia 19.08.1994r., tj. DzU 2011r., nr 231, poz. 1375(Act on Protection of Psychiatric Health, Act of 2011, Pub. L. No. 231, Stat. 1375 – August 19, 1994); Ustawa o przeciwdziałaniu narkomanii, z dnia 29.07.2005r., DzU 2005r., nr 179, poz. 1485, ze zm. (Act on Prevention of Drug Addiction, Act of 2005, Pub. L. No. 179, Stat. 1485 – July 29, 2005); Ustawa prawo o ruchu drogowym z dnia 20.06.1997r., tj. DzU 2005r., nr 108, poz. 908, ze zm. (Act on Trafic, Act of 2005, Pub. L. No. 108, Stat. 908 – June 20, 1997) (in Polish).
 
11.
Beauchamp LT, McCullough BL. Medical Ethics. The moral responsibilities of Physicians, Englewood Cliffs, NJ, Prentice Hall 1984: 84.
 
12.
Henson VL, Vickery DS. Patient self discharge from the emergency department: who is at risk? Emerg Med J. 2005 Jul; 22(7): 499-501.
 
13.
Feenan D. Capacity to decide about medical treatment. Br J Hosp Med. 1996 Sep 18-Oct 1; 56(6): 295-7.
 
14.
Grubb A. Treatment without consent: adult – Re C (Refusal of Medical Treatment), Med Law Rev. 1994 Spring; 2(1): 92-5.
 
15.
Dumiet-Nagórska T. Świadoma zgoda pacjenta w ustawodawstwie polskim (Informed Consent in Polish Legislation). PiM 2000; 6-7: 83. (in Polish).
 
16.
Świderska M, Nesterowicz M. Ustawa o prawach pacjenta i Rzeczniku Praw Pacjenta. Komentarz (Act on a Patient’s Right and a Patient’s Rights Spokesman. Comments), Warszawa 2009: 148. (in Polish).
 
17.
Resolution of Supreme Court, 27.10.2007 r., sygn. III CK 155/05, OSN Izba Cywilna 2006r., No. 7-8, Stat. 137.
 
18.
Kardas P. Zgoda pacjenta na zabieg leczniczy a problem odpowiedzialności karnej lekarza za niewypełnienie obowiązku zapobiegania skutkowi (Patients’ Consent for Curative Procedurę and Penal Responsibility for Not Obviating of Results). PS 2005; 10: 81. (in Polish).
 
19.
Judgment of Supreme Court, 23.11.2007, No., IV CSK 240/07, OSNC 2009 r., No. 1, Stat. 16.
 
20.
The Constitution of the Republic of Poland as of 2.04.1997r., DzU 2007 r., No. 78, Stat. 483 (in Polish).
 
21.
Rozporządzenie w sprawie trybu doprowadzania, przyjmowania i zwalniania osób w stanie nietrzeźwości oraz organizacji izb wytrzeźwień i placówek utworzonych lub wskazanych przez jednostkę samorządu z dnia 11.02.2004 r., DzU 2004 r., nr 20, poz. 192, terytorialnego (Disposition on Setting on, Taking Charge and Dismission of Persons in Drink and Establishing of Sobering Chamber Organised by Territorial Administrative, Act of 2004, Pub. L. No. 20, Stat. 192 – February 11, 2004) (in Polish).
 
22.
Dukiet-Nagórska T. Autonomia pacjenta a polskie prawo karne (Patients’ Autonomy and Polish Penal Law). O cyna, Warszawa 2008 (in Polish).
 
23.
Dworkin G. Paternalism. In: Gorovitz S, Jameton LA, Macklin R, et al. eds. Moral Problems in Medicinie. Englewood Cliffs, NJ, Prentice-Hall 1983: 196-199.
 
eISSN:1898-2263
ISSN:1232-1966
Journals System - logo
Scroll to top