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下一个王碧雯怎么办？
http://www.sina.com.cn 2011年09月21日14:01 南方日报
HIV携带者求医遭遇法理制度技术“三重门”
■新闻纵深
截至去年10月底，广东省累计报告艾滋病病毒感染者和病人28039例，而在2006年底，数量仅仅过万。越来越多HIV病毒携带者的出现，其就医特别是“手术难”的问题，再次走进公众的视野。
NGO组织北京益仁平中心设置了艾滋法律咨询热线，收到过众多同样遭遇者的咨询。今年5月中国艾滋病病毒携带者联盟发布的《关于解决我国艾滋病病毒感染者和艾滋病病人“手术难”问题建议》显示，仅在这家民间组织走访的123位HIV病毒携带者中，就收集了38个“手术难”的案例。
“HIV病毒携带者的就医及手术问题关系到的不仅是这个群体，也影响到整个社会。”这次王碧雯的病情可以通过媒体围观与领导重视来解决，下一个“王碧雯”怎么办？
法律没有罚则医院屡拒艾滋患者
广东德纳律师事务所律师厐琨在接受记者采访时表示，无论患者是否为HIV病毒携带者，医院拒收病人均属违法行为。
“就算医院没有医治病人的条件，也应积极为病人寻找合资格的医院。”厐琨引用“医院首诊负责制”的相关规定称：凡来医院就诊的病人，均实行医院首诊负责制。医院对诊疗范围内的病人一律不得拒诊。”国家2006年初颁布的《艾滋病防治条例》中也明确规定：医疗机构不得因就诊的病人是艾滋病病毒感染者或者艾滋病病人，推诿或者拒绝对其其他疾病进行治疗。
然而，医院拒绝HIV病毒携带者就诊或者手术的情况仍然屡有发生。反艾滋病歧视多年的北京益仁平中心负责人陆军指出，“我认为最重要的一点是加强法律的可操作性。”法律里并没有设计“罚则”，没有规定拒收艾滋病人的医院应该承担什么责任，接受什么惩罚，这就导致艾滋病毒携带者在就医时还是屡遇难题。
公益律师刘巍向记者证实，艾滋法律咨询热线接收很多HIV病毒携带者就医遭遇“闭门羹”的案例，然而迄今为止，没有任何一家医院因为拒收HIV病毒携带者遭到起诉，或者受过处罚。
“定点治疗”没有综合救治能力
据了解，目前我国对HIV病毒携带者的收治采取“定点治疗”的制度，卫生行政部门曾规定各地指定传染病医院，专门负责收治危重、有伴发疾病等艾滋病人。
陆军指出，这个制度广受诟病，因为它存在两个弊端：首先，收治HIV病毒携带者的医院在传染病防治方面擅长，但对其他疾病的医治水平往往不高，比如专业性强的烧伤科，很多定点医院就根本没有；其次，一些综合实力很强的医院就可以以此为由，拒收HIV病毒携带病患。这两个弊端相叠加，就导致了很多HIV病毒携带者求医无门。陆军认为，定点治疗制度应该适时取消。
中国艾滋病病毒携带者联盟也在调查报告中指出，很多“艾滋病定点医院”不具备综合性医院的学科体系和救治能力，无法为感染者提供综合性诊疗服务。该组织称，应将艾滋病治疗纳入常规医疗体系，建议政府依法查处医疗机构推诿或拒绝治疗艾滋病人的行为，并设立专门的监督、投诉平台。
担心病毒传播非天大理由
在王碧雯事件中，曾有媒体走访广州多家综合性医院，得到的答复是一个“基本共识”：“烧伤创口如果感染，极易导致艾滋病病毒的传播，没有艾滋病治疗经验和专业技术的医院，确实不敢轻易收治，这是对其他病人的医疗安全负责。”
对此，陆军认为，卫生部出台过《医院感染管理办法》，达标的医院理应可以在治疗中抵挡各种传染病毒的传播，HIV也包括在内，在一般治疗中，肝炎病毒携带者等患者都可以得到普通的治疗，HIV病毒的传播途径类似，不应该区别对待。
他进一步指出，如果说HIV会在治疗中有传染的风险，那么同样的环境下，肝炎病毒等其他传染病是不是也有传染的风险？“如果是这样，那么肝炎病毒携带者同样不能接受手术，因为也可能会对其他病人的医疗安全产生损害。”一位不愿透露姓名的医生向记者介绍，其实只要做好严格的消毒，HIV病毒携带者并不是不能做手术，“给艾滋病人做手术在国内早已不是首例，只是一旦出现事故，风险太大，一般的医院很少愿意承担这个责任。”
刘巍指出，“很多医院会建议艾滋病患者采取保守治疗，不肯为病人进行手术，但这并不属拒收行为，也不会被控违法。”
南方日报记者 蒋哲
实习生 许漪淳
艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复
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| 图示∶2011年5月正式出版的《中国特色医疗金鉴》登载的刘君主任及其机构事迹 |
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Wang Biwen how to do next?
http://www.sina.com.cn 2011 年 09 月 21 日 14:01 Nanfang Daily
Medical treatment of HIV carriers face a legal system technology, "triple-gate"
■ News in depth
As of the end of October last year, Guangdong has reported HIV infections and 28,039 cases of patients, and in the end of 2006, the number of just over 10000. More and more the appearance of people with HIV, the doctor especially the "operation difficult" issue, once again into public view.
Beijing Yi Ren Ping Center NGO organizations set up AIDS Legal Hotline, received a number of those who suffered the same advice. China in May this year, people living with HIV Alliance issued "on the resolution of China's HIV-infected people and AIDS patients' surgical difficulties" Proposal "shows that only in this civil society organizations visited 123 HIV virus carriers, has collected 38 "operation difficult" case.
"HIV virus in medical and surgical problems related to not only this group, but also affect the entire society." Condition of the Wang Biwen crowd through the media attention and leadership to solve, the next "Wang Biwen" how to do?
Penalty law does not reject HIV patients repeated hospital
Dana Law Firm Long Guangdong Kun, said in an interview with reporters, regardless of whether the HIV virus in patients, the hospital refused the patient an offense.
"Even if the hospital does not treat the patient's condition should also be actively looking for a qualified hospital patient." Pang Kun reference "hospital's first patient responsibility" of the relevant provisions of the said: to the hospital where patients are first diagnosed responsibility to implement the hospital . Hospital for treatment of patients within the clinic are not allowed to refuse. "State promulgated in early 2006," HIV Prevention Act, "also clearly states: medical treatment of patients is not due to HIV or AIDS patients, buck-passing or rejecting its treatment of other diseases.
However, the hospital refused treatment of HIV carriers or surgery is still around. Years of anti-AIDS discrimination Yi Ren Ping Beijing Center for the Army said, "I think the most important point is to enhance the operability of the law." Law where no design "penalty" does not require rejection of people with AIDS should bear hospital any responsibility, to accept the penalties, which led to HIV victims in the medical treatment or repeated questions.
Liu Wei confirmed to reporters that public interest lawyers, legal advice hotline to receive a lot of HIV virus HIV medical encounter "cold" cases, but so far, no hospital because of rejection of HIV carriers have been sued, or received punishment.
"Designated treatment" there is no comprehensive treatment capacity
It is understood that China's HIV-carriers admitted to "designated treatment" system, provides local health administrative departments have designated infectious disease hospital, dedicated to critically ill treated, there is associated with diseases such as AIDS.
Army pointed out that this system is widely criticized because it has two drawbacks: First, the hospital treated people with HIV prevention and treatment of infectious diseases are good, but the level of other diseases, treatment is often not high, such as highly specialized burn unit Many designated hospitals would not; Second, some strong comprehensive strength, the hospital can be a pretext, refused to carry the HIV virus patients. The overlay of these two drawbacks, has led to a lot of medical treatment of HIV carriers nowhere. Army believes that the treatment system should be fixed in due course cancel.
Chinese HIV carriers Union is also investigating reports that a lot of "AIDS designated hospitals" hospitals do not have a comprehensive disciplinary system and treatment capacity, unable to provide comprehensive HIV treatment services. The organization said the HIV treatment should be incorporated into conventional health care system, recommended that the Government prosecute prevarication or refuse medical treatment of people with AIDS, behavior, and set up a special monitoring, complaints platform.
Big reason to worry about non-transmission of the virus
In Wang Biwen event, there were a number of media visits to general hospital in Guangzhou, the answer is a "basic consensus": "If you burn wound infection can easily spread the virus that causes AIDS, an AIDS treatment hospital experience and expertise, does not easily treated, which is responsible for the safety of other patients' medical. "
In this regard, the Army believes that the Ministry of Health issued the "Hospital Infection Control Measures", standard hospital should be able to withstand the treatment of various infections in the spread of the virus, HIV is also included in the general treatment in patients with hepatitis virus carriers, etc. can get ordinary treatment, HIV virus transmission similar to the should not be treated differently.
He further pointed out that if in the treatment of HIV infection in risk, then the same environment, hepatitis viruses and other infectious diseases is also the risk of infection? "If so, then the hepatitis B virus carriers also can not undergo surgery because the patient may also have other medical cause harm security." Doctors who declined to be named, told this reporter, they can simply do a strict disinfection, HIV not surgery is not a virus, "an operation to AIDS in the country had not first, but once an accident, the risk is too large, general hospitals rarely willing to take on this responsibility."
Liu Wei pointed out that "many hospitals will recommend conservative treatment of AIDS patients, the patient refused surgery, but that does not belong to reject the act, not charged with an offense."
Zhe Jiang Nanfang Daily Correspondent
Xu Yi Chun intern
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