麻醉醫生涉摸兩產婦胸
【明報專訊】麻醉科醫生張啟旋涉嫌先後在參與剖腹產子手術時非禮兩名產婦，違反專業操守，昨日在醫務委員會紀律聆訊中被控8項罪名。在聆訊中作證的女護士指出，張藉詞為產婦作產後感覺測試，用手觸摸產婦胸部及揑其乳頭，她從未見過麻醉醫生做這種測試，感到驚訝故向上級報告。聆訊未完，今日繼續。
控罪指出，張啟旋於2012年2月25日藉詞向A病人作剖腹產後感覺測試，用手觸摸女病人的左邊胸部及揑乳頭。控方證人聖保祿醫院女護士陳家欣（譯音）作證時供稱，張啟旋當時表示要向她示範如何檢查病人麻醉程度，並用手指打圈，由病人左胸下方肋骨部位往上移動，經鎖骨、頸及腋下。張又詢問病人是否有感覺，病人A表示有感覺。
捏乳頭試病人感覺 女護驚訝
張啟旋其後又表示，要測試A病人被揑的感覺，並重複之前的動作，並揑病人的乳頭。女護士表示，曾與張啟旋一同進行約百次手術，未見過他做這種測試，也從未見過麻醉醫生做這種測試，感到驚訝，故向上級報告。 此案連同沒有妥善保存病人脊髓麻醉後的感覺測試報告，以及不恰當處方鎮靜劑 midazolam，共被控5項罪名。
正常用冰或針 胸膛以下測試
另外，控罪指出，事隔兩日即2012年2月27日，張不適當觸摸B女病人左邊乳房，又無妥善保存病人在脊髓麻醉後的感覺測試報告，以及不恰當處方鎮靜劑 midazolam給病人B，共被控3項罪名。
有麻醉科醫生表示， 脊髓麻醉是半身麻醉，上半身可以活動，讓產婦可在分娩後抱嬰兒，但在麻醉藥力未過之前，約有兩三小時產婦腳部麻痹無力、不能走動。若醫生認為麻醉時沒有出什麼大問題，剖腹分娩後麻醉科醫生毋須再去看病人。若醫生要測試病人感覺，通常會用冰或針測試病人反應，一般接觸胸膛以下位置已足夠，毋須觸摸病人胸部。
曾涉七度非禮孕婦脫罪
根據資料，張啟旋2000年曾被控於95年至99年間，分別於港安醫院及山頂明德醫院婦產科病房內，七度非禮孕婦，當中包括5名日裔婦女，並於同年被判監半年，翌年上訴l得直脫罪。
(13/5/2015 明報)
一個普通市民，看了這則新聞可能會好大反應，有無搞錯，咁咪喺非禮囉！别大驚小怪，醫生非禮並不稀奇，本blog以前寫過，沒有寫的多的是。上面新聞尾二段講，有麻醉科醫生認為毋須觸摸病人胸部，可惜這句話需要有註腳，因為在「如果」甚麽甚麽的情況需要下，麻醉科醫生如這聆訊的張啓旋，本身是醫生，就可以內外全科，上下其手，全方位無微不至地照顧病人。上面紀律聆訊的案情只涉摸胸，之前日裔婦女案，上訴由清洪代表，就涉及名副其實的上下其手了。標少不會亂講，有判辭為證。從2000年張醫生受審那件案的判辭可見，在非禮審訊時，被告傳召了另一位麻醉師Dr Tsui作專家證供，顯示如果有需要可以對乳房做出很多親蜜檢查，但我這門外漢當然不懂，因為涉及would be necessary同if，但是「有需要」、「如果」，好似是對病人而言，而不是醫生有可能的sexual fantasy。這種檢查是否有需要，就要看醫委會主持聆訊的醫學專家了，這些東西，法官懂個屁。可惜醫委會公信力有限，醫醫相衛乃等閒事。下面這段是其中一段當年辯方傳召專家的其中一段證供：
"(a) An examination of the patient's nipples and breast by palpation would be necessary if, for example, the patient complained of any discomfort in her breast or nipples. This is a usual and common complaint in the early post-delivery period. It could, for example, be due to breast engorgement or abscess formation. It would be necessary for a clinician in Dr Cheung's position to examine the patient's breast and to give advice on treatment, or to refer her to an appropriate specialist as indicated. It is important to note that all anaesthetists in Hong Kong are fully qualified medical doctors who should have the requisite basic training to respond to a patient's condition by carrying out the appropriate clinical examination.
那日裔產婦在分娩後，拒絕餵哺母乳，是她的選擇喎，然則要逼她餵母乳，抑或是醫生想吃人奶。麻醉醫生有「需要」為她檢查嗎？不應由婦產科醫生去做嗎？張醫生何止檢查乳房，據原審裁判官的講法，他還檢查下體，還是很intrusive那種：
"(Dr Tsui) in his evidence in court, adopted his expert witness report, .... and dealt with the complaint of (the victim), which was now proved. Whilst this court was persuaded by him regarding examination particularised in paragraph 3(a), (b) and (c) i.e. as being medically necessary, this Court must say he did not in the said report really support the touching of the vagina and the opening of the vagina with fingers as being medically necessary. He just said generally that these examinations, including the questionable touching and opening of vagina, which he had just put in as the heading, as necessary. He said however that the examination was merely to ascertain if the patient was suffering from post-partum haemorrhage.
He then followed on and said that examination involved the inspection of vaginal pads for any excessive blood loss and the inspection of the genital area for any bleeding. Surely the examination necessary in these circumstances, in order to check the blood loss, was merely visual examination. This Court was not persuaded that examination to check if there was excess blood loss would involve or require one to touch or open the vagina. PW10 in effect supported the view that the checking could be done merely by looking at the vaginal pad."
我也不好意思把上面兩段譯出來。我真不明白，某些醫生對婦女身體有特別照顧的興趣，其實可以做整容醫生，做隆胸或修補甚麽的，為甚麽要做獸醫？噢！不是veterinary surgeon, 而是禽獸醫生呀！
2000年那件案的判辭，連結在此：HKSAR and Cheung Kai Shuen HCMA 238/2001
藉詞做產後感覺測試
控罪指出，張啟旋於2012年2月25日藉詞向A病人作剖腹產後感覺測試，用手觸摸女病人的左邊胸部及揑乳頭。控方證人聖保祿醫院女護士陳家欣（譯音）作證時供稱，張啟旋當時表示要向她示範如何檢查病人麻醉程度，並用手指打圈，由病人左胸下方肋骨部位往上移動，經鎖骨、頸及腋下。張又詢問病人是否有感覺，病人A表示有感覺。
捏乳頭試病人感覺 女護驚訝
張啟旋其後又表示，要測試A病人被揑的感覺，並重複之前的動作，並揑病人的乳頭。女護士表示，曾與張啟旋一同進行約百次手術，未見過他做這種測試，也從未見過麻醉醫生做這種測試，感到驚訝，故向上級報告。 此案連同沒有妥善保存病人脊髓麻醉後的感覺測試報告，以及不恰當處方鎮靜劑 midazolam，共被控5項罪名。
正常用冰或針 胸膛以下測試
另外，控罪指出，事隔兩日即2012年2月27日，張不適當觸摸B女病人左邊乳房，又無妥善保存病人在脊髓麻醉後的感覺測試報告，以及不恰當處方鎮靜劑 midazolam給病人B，共被控3項罪名。
有麻醉科醫生表示， 脊髓麻醉是半身麻醉，上半身可以活動，讓產婦可在分娩後抱嬰兒，但在麻醉藥力未過之前，約有兩三小時產婦腳部麻痹無力、不能走動。若醫生認為麻醉時沒有出什麼大問題，剖腹分娩後麻醉科醫生毋須再去看病人。若醫生要測試病人感覺，通常會用冰或針測試病人反應，一般接觸胸膛以下位置已足夠，毋須觸摸病人胸部。
曾涉七度非禮孕婦脫罪
根據資料，張啟旋2000年曾被控於95年至99年間，分別於港安醫院及山頂明德醫院婦產科病房內，七度非禮孕婦，當中包括5名日裔婦女，並於同年被判監半年，翌年上訴l得直脫罪。
(13/5/2015 明報)
一個普通市民，看了這則新聞可能會好大反應，有無搞錯，咁咪喺非禮囉！别大驚小怪，醫生非禮並不稀奇，本blog以前寫過，沒有寫的多的是。上面新聞尾二段講，有麻醉科醫生認為毋須觸摸病人胸部，可惜這句話需要有註腳，因為在「如果」甚麽甚麽的情況需要下，麻醉科醫生如這聆訊的張啓旋，本身是醫生，就可以內外全科，上下其手，全方位無微不至地照顧病人。上面紀律聆訊的案情只涉摸胸，之前日裔婦女案，上訴由清洪代表，就涉及名副其實的上下其手了。標少不會亂講，有判辭為證。從2000年張醫生受審那件案的判辭可見，在非禮審訊時，被告傳召了另一位麻醉師Dr Tsui作專家證供，顯示如果有需要可以對乳房做出很多親蜜檢查，但我這門外漢當然不懂，因為涉及would be necessary同if，但是「有需要」、「如果」，好似是對病人而言，而不是醫生有可能的sexual fantasy。這種檢查是否有需要，就要看醫委會主持聆訊的醫學專家了，這些東西，法官懂個屁。可惜醫委會公信力有限，醫醫相衛乃等閒事。下面這段是其中一段當年辯方傳召專家的其中一段證供：
"(a) An examination of the patient's nipples and breast by palpation would be necessary if, for example, the patient complained of any discomfort in her breast or nipples. This is a usual and common complaint in the early post-delivery period. It could, for example, be due to breast engorgement or abscess formation. It would be necessary for a clinician in Dr Cheung's position to examine the patient's breast and to give advice on treatment, or to refer her to an appropriate specialist as indicated. It is important to note that all anaesthetists in Hong Kong are fully qualified medical doctors who should have the requisite basic training to respond to a patient's condition by carrying out the appropriate clinical examination.
那日裔產婦在分娩後，拒絕餵哺母乳，是她的選擇喎，然則要逼她餵母乳，抑或是醫生想吃人奶。麻醉醫生有「需要」為她檢查嗎？不應由婦產科醫生去做嗎？張醫生何止檢查乳房，據原審裁判官的講法，他還檢查下體，還是很intrusive那種：
"(Dr Tsui) in his evidence in court, adopted his expert witness report, .... and dealt with the complaint of (the victim), which was now proved. Whilst this court was persuaded by him regarding examination particularised in paragraph 3(a), (b) and (c) i.e. as being medically necessary, this Court must say he did not in the said report really support the touching of the vagina and the opening of the vagina with fingers as being medically necessary. He just said generally that these examinations, including the questionable touching and opening of vagina, which he had just put in as the heading, as necessary. He said however that the examination was merely to ascertain if the patient was suffering from post-partum haemorrhage.
He then followed on and said that examination involved the inspection of vaginal pads for any excessive blood loss and the inspection of the genital area for any bleeding. Surely the examination necessary in these circumstances, in order to check the blood loss, was merely visual examination. This Court was not persuaded that examination to check if there was excess blood loss would involve or require one to touch or open the vagina. PW10 in effect supported the view that the checking could be done merely by looking at the vaginal pad."
我也不好意思把上面兩段譯出來。我真不明白，某些醫生對婦女身體有特別照顧的興趣，其實可以做整容醫生，做隆胸或修補甚麽的，為甚麽要做獸醫？噢！不是veterinary surgeon, 而是禽獸醫生呀！
2000年那件案的判辭，連結在此：HKSAR and Cheung Kai Shuen HCMA 238/2001
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