*For medical professionals only
What would you do if you came across a severely abused child in the clinic?
Writing | Wan Shunshun
Source | “Medical Community” Public Account
Doctor suspended for 6 months from practice!
The outpatient department was warned, fined, and cancelled related departments!
It all started last October…
In October 2021, Ji Moumou, a gynecologist in the outpatient department of a private hospital in Donggang City, met a pregnant girl under the age of 14, and the person who accompanied her to the hospital for an induced abortion was not The parents of the child are Sun Mouru, a netizen she met on the Internet.
In the absence of the guardian’s accompaniment and signature confirmation, the gynecologist Ji Moumou performed the induced abortion operation for the girl, and did not report the situation to the public security organs or relevant departments.
But behind the abortion operation, Sun Mouru repeatedly raped girls, causing her to become pregnant and miscarried twice.
On May 27, the Supreme People’s Procuratorate issued a notice of accountability:
In addition to Sun Mouru, who was sentenced to ten years in prison for rape, Ji Mou, a gynecologist in the outpatient department, was suspended by the local health bureau for failing to perform mandatory reporting obligations. Administrative penalty for six months of practicing activities. The outpatient department involved was given an administrative penalty of a warning, confiscation of illegal gains, a fine of 20,000 yuan, and the relevant departments were cancelled.
Physician’s Responsibility for Vigilance
Coincidentally, the first case in Shandong Province that was filed for investigation after compulsory reporting was reported to a doctor in Weihai City.
According to the “Shandong Provincial Procuratorate”, in August 2020, a hospital in Weihai City admitted a 10-year-old girl who was 21 weeks pregnant. The receiving doctor was aware of the possibility of sexual assault and reported it to the health authority in accordance with the mandatory reporting system. His actions saved an abused child. On January 6, 2021, Liu Moumou was sentenced to 12 years in prison for rape.
Physicians are no strangers to mandatory reporting.
“In academics, we call it the doctor’s vigilance responsibility. The Law on the Prevention and Treatment of Infectious Diseases stipulates that doctors have a statutory reporting obligation. If a suspected infectious disease is found, they must report to the hospital accordingly. Similar situations include adverse drug reactions, mass medical incidents (the “big head doll” incident in Fuyang, Anhui), etc.”
Wang Yue, a professor at the Department of Medical Ethics and Law at the School of Medical Humanities of Peking University, said in an interview with the “Medical Community” that for the above types of situations and some obvious criminal cases such as slashing and gunshot wounds , the doctor did a good job of fulfilling his reporting obligations. However, when minors are violated, the concept of whether to report and how to report is rather vague.
In Article 33 of the newly revised “Physician Law of the People’s Republic of China”, there are two types of relevant situations that doctors should report to their medical and health institutions or relevant departments and institutions: discovering patients Suspicion of injury or abnormal death, and other circumstances prescribed by laws and regulations.
Many doctors are completely ignorant of the compulsory reporting system for cases of violations against minors, and hospitals have not conducted any instructional studies.
“The administrative penalty of suspending practice activities for six months is also a wake-up call for the industry.” Wang Yue believes that it is not enough for the medical industry to only look at the relevant regulations of the department. But in fact, the National People’s Congress, the Supreme People’s Court, the Supreme People’s Procuratorate, and the Ministry of Public Security have issued some medical-related laws and judicial interpretations, which also need to be paid attention to.
The mandatory reporting system for cases of violations against minors is involved in the Law of the People’s Republic of China on the Protection of Minors, which was revised and implemented in June 2021. Reporting violations is no longer an ethical choice but a legal obligation.
According to the “Opinions on Establishing a Compulsory Reporting System for Cases Infringing upon Minors (for Trial Implementation)” (Gao Jianfa [2020] No. 9), it is found during work that minors have suffered or are suspected of suffering from Wrongful infringement and situations in which it is at risk of wrongful infringement include:
(1) Minors have suffered or are suspected of having suffered abnormal damage to their reproductive organs or private parts;
(2) Female minors under the age of 14 have suffered or are suspected of being sexually assaulted, pregnant, or miscarried;
(3) Pregnancy or miscarriage caused by female minors over the age of fourteen who have suffered or are suspected of being sexually assaulted;
(4) The minor has multiple physical injuries, severe malnutrition, unclear consciousness, and is or is suspected of being subjected to domestic violence, bullying, abuse, beating, or being anesthetized. ;
(5) Minors are disabled or died due to abnormal reasons such as suicide, self-injury, work-related injury, poisoning, being anesthetized, or beaten;
(6) Minors are abandoned or left unattended for a long time;
(7) It is found that the source of the minor is unknown, missing, or has been abducted, sold or bought;
(8) It is found that minors are organized to beg;
(9) Other circumstances that seriously infringe on the physical and mental health of minors or where minors are facing the danger of illegal infringement.
Among them, the pregnancy and miscarriage of female minors under the age of 14 must be reported, and medical workers should immediately report or report to the public security organs when they find this situation.
1st reported physician and 2854 cases
The establishment of the “Compulsory Reporting System for Cases of Violation against Minors” originated from doctors at the Children’s Hospital Affiliated to Zhejiang University School of Medicine.
According to People, as early as 2017, a female doctor at this hospital met a 13-year-old girl in the emergency department. The girl’s lower body was torn and bleeding. How did you get hurt when asked? The man accompanying him said hesitantly that he had been hit. The doctor alerted the police.
The violation of minors is extremely concealed. Can a system be established so that doctors can report to the case when they encounter such a situation? The prosecutor handling the case thought.
“The angle of mandatory reporting is to solve the problem of ‘difficulty in finding’.” Tong Lihua, director of the Beijing Juvenile Legal Aid and Research Center, said in an interview with Xinhua News Agency, such as schools, hospitals, children Welfare institutions, training institutions, etc. are all organizations that have close contact with the juvenile industry.
Deng Liqiang, member of the Standing Committee of China Health Law and deputy director of Beijing Huawei Law Firm, said that he has never encountered a case in which a doctor was held accountable for not fulfilling the reporting system, “This is a manifestation of social progress. Women Women and children have an irreplaceable role in the development of society, and the protection of the rights and interests of women and children is also a sign of social civilization.”
Article 55 of the “Physician Law of the People’s Republic of China” also stipulates the legal responsibility of doctors for not reporting, “the competent health department of the people’s government at or above the county level shall order corrections and give warnings; If the circumstances are serious, order to suspend practicing activities for more than six months but less than one year or even revoke the doctor’s practicing certificate.”
“The six-month suspension of practicing activities is the lightest punishment in six months to one year, because there is a criminal offense behind it, otherwise a warning may be given.” Wang Yue said.
Whether there will be retaliation after reporting is what many doctors worry about. “Doctors should be protected. For example, after a doctor reports to the medical department and security department of the hospital, the medical department and security department The department must take protective measures for doctors and send people to the scene.”
Deng Liqiang said that while performing his duties, the safety of the doctor’s life is also very important. Doctors can ask their superiors for consultation before reporting, or ask the medical department to make judgments together, so as to avoid themselves becoming the focus of conflicts.
Wang Yue believes that according to the “Physician Law”, doctors can report to the medical department, and then the medical department will report to the public security organ on behalf of the hospital. It may be more appropriate for a legal entity to report instead of an individual doctor. .
It is understood that from May 2020 to March 2022, 2,854 cases involving clues in relevant cases handled by the procuratorate came from mandatory reports.
“Not only protect minors. In the daily work of doctors, patients themselves are vulnerable groups, in addition to minors, mental patients, elderly people with dementia, women, disabled people These vulnerable groups deserve the attention of doctors.” Wang Yue added.
Source: Medicine
Editor in charge: Wan Shunshun
Proofreading: Zang Hengjia