ACADEMIC RESEARCH•學術研究 2020 UMAGAZINE 22•澳大新語 64 不過，在某些情況下，行使醫療行為不 要求知情同意。第一種情況涉及緊急醫 療手術或治療，其押後將導致生命有危 險，或導致身體或健康有嚴重危險（第 150條第2款a項）。在這種情況下，醫生 或依法獲許可人士應該根據職業規則， 分析情況是否確實危急到不能等待病人 的知情同意。第二種情況，是指病人和 醫生或依法獲許可人士之前曾就某種醫 療行為達成一致，而當前考慮採取的另 一不同醫療行為是之前達成一致的醫療 行為的延伸，旨在避免對病人的生命、 身體或健康造成危害（第150條第2款b 項）。在這兩種情況下，醫生或依法獲 許可人士應安全地得出結論，倘若病人 有條件表達其意見，就不會拒絕醫生或 依法獲許可人士考慮採取的醫療手術或 治療。因此，這些情況被稱為「推定同 意」。最後，第三種情況（第150條未作 規範）涉及病人的無行為能力（例如 《澳門民法典》第111條及其後條文 規定的未成年人、禁治產人或準禁治 產人）。在這種情況下，醫生或依法 獲許可人士即使毋須獲得病人的知情 同意，但仍須獲得病人法定代表人的 知情同意10。 此外，我們還需要知道第150條所規定 的犯罪是公罪、半公罪還是私罪。界定 這一點很重要，因為它決定了誰可以採 取行動對被告提起刑事訴訟。如果規 範某種罪狀的法律沒有說明任何內容， 就屬於公罪；如果法律規範表明刑事訴 訟程序取決於告訴，則屬於半公罪；如 果法律規範表明刑事訴訟程序取決於自 訴，則屬於私罪。第150條第4款規定， 非經告訴不得進行刑事程序，所以這 屬於半公罪。在這種情況下，只有當作 為被害利益持有人的被害人提出告訴， 或者如果被害人已去世，則由法律規定 的其他人提出告訴，檢察院才能提起刑 事訴訟（第105條第1款和第2款）。因 此，如果沒有告訴，檢察院就無法對被 告提起刑事訴訟。 總而言之，如果醫生或依法獲許可人士 瞭解應該如何獲得病人的有效知情同 or legally authorised person, are not destined to therapeutic purposes. For the first situation, the person may commit a crime regarding an illegal practice of profession in line with article 3229, while the second situation should be considered a crime of offence to physical integrity in accordance with article 144. However, there are some situations in which informed consent is not required for the exercise of medical acts. The first situation involves urgent medical interventions or treatments whose delay implies danger to life or serious danger to body or health (article 150/2/a). In this situation, the doctor or legally authorised person should analyse, in accordance with leges artis, whether a medical act is so urgent that it cannot wait for the patient’s informed consent. The second situation pertains to an extension of a medical act before agreed between the doctor or legally authorised person and the patient, extension that implies another different medical act which before has not been agreed upon and is considered as a way to avoid danger to the patient’s life, body, or health (article 150/2/b). In both situations, the doctor or legally authorised person should safely conclude that the consent for the medical interventions or treatments would not be rejected if the patient had the condition to express it. Therefore, these situations are called ‘Presumed Consent’. Finally, the third situation, which is not regulated in article 150, refers to a patient’s incapability (such as minors, interdicts, disabled persons, regulated in article 111 and following of the Macao Civil Code); in this situation, the doctor or legally authorised person still needs to obtain informed consent from the patient’s legal representative, even though the patient’s informed consent may be dispensed with10. Further, we also need to know if the crime regulated in article 150 is a public crime, semi‑public crime, or particular crime. This is very important because it determines who can take action to initiate a criminal procedure against the defendant. If a legal norm that regulates a type of crime does not indicate anything, it is a public crime; in a case in which the legal norm indicates that the criminal procedure depends on a complaint, it is a semi-public crime; and, if a legal norm shows that the criminal procedure depends on a particular accusation, it means the crime has a particular nature. As article 150/4 indicates that the criminal procedure depends on a complaint, it is a
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