臨床神経学

第48回日本神経学会総会

<教育講演4>
神経内科臨床と権利擁護の問題点整理

成田 有吾

三重大学医学部附属病院医療福祉支援センター〔〒514-8502 三重県津市江戸橋2-174〕

To advocate patient's right is an inevitable assignment of all neurologists who have clinical activities for patients with neurological diseases, though the assignment has very broad fields and is impossible to perform by one. The author summarized present issues of guardianship, the program to protect the social welfare rights in communities, and advance directives for patients with neurological diseases. The new guardianship for adults in Japan started in 2000 and has been increasingly used mainly for the demented. Proxy decision making for a medical care by the guardian is still unsettled. The author raised a possible question on identification of the person who wants medical certification for guardianship and his/her intention to obtain such a document, in order to avoid unexpected troubles in the family or involved parties. Replies about the identification from an inspector at a family court, lawyers, judicial scriveners, social workers and Japan National Council of Social Welfare were shown on the table. In May 2007, the Ministry of Health, Labour and Welfare presented the guideline of process to decide the end-of-life-care. But advance directives for medical cares are still controversial in Japan. Multidisciplinary team to advocate patients' rights was stressed in this presentation.

(臨床神経, 47:779−782, 2007)
key words:成年後見制度, 本人確認, 医療同意, 事前指示書

(受付日:2007年5月16日)