医疗损害责任研究

发布时间：2018-03-14 23:00

本文选题：医疗损害　切入点：侵权责任　出处：《新疆师范大学》2012年硕士论文　论文类型：学位论文

【摘要】：医疗损害责任既是社会关注的热点问题，也是侵权责任法的难点问题，它深度体现了医患双方的博弈和妥协。医疗行为的特殊性决定了医疗损害责任与其他侵权责任的不同。立法者不仅要在医疗机构和患者之间平衡利益，而且还要在医疗卫生事业的长远发展与全体患者利益之间做出价值取舍。《侵权责任法》统一了医疗损害责任的概念，终结了二元化的赔偿标准，对解决医疗纠纷有重大意义。但一些问题仍未从根本上解决。本文从医疗损害责任的概念入手，明确医疗损害责任性质——从有利于保护患者合法权益出发，定性为侵权责任性质，阐述了医疗损害的法理基础，指出了医疗损害责任制度的不足，提出了完善医疗损害责任制度的建议。文章正文分为四个部分：第一部分为医疗损害责任概述。首先界定了医疗事故、非医疗事故，进而定义医疗损害责任，明确医疗损害责任的性质为侵权责任。其次，阐述医疗行为概念和特征。第二部分为医疗损害责任的构成要件。这是本文的理论难点。首先，论述医疗损害责任的归责原则，以过错责任原则为主，辅之推定过错原则和无过错原则。其次，阐述医疗损害责任的构成要件，即医疗过错、损害事实、医疗过错与损害事实存在因果关系，并对医疗过错的认定标准，损害范围和因果关系的认定进行了探讨。再次，介绍了我国《侵权责任法》规定免责事由，分析了免责事由的依据。然后，界定医学事故技术鉴定与医疗过错司法鉴定，，厘清了二者之间的关系。最后，考察了国外医疗损害诉讼中举证责任分配，阐述了我国医疗损害诉讼中的举证责任分配的立法选择。第三部分对医疗损害责任制度的不足进行了探析。我国《侵权责任法》虽然统一了医疗损害责任概念、赔偿标准等，但现行医疗损害责任仍存在一些问题：二元化的医疗损害鉴定制度仍未解决；举证责任的分配仍不尽合理；未规定医疗损害赔偿限额制度；医疗机构的免责事由规定得不够周全；未规定医疗责任保险制度；未构建多元化的解决医疗损害赔偿纠纷的途径。第四部分为完善医疗损害责任的建议。这是该文的落脚点。针对医疗损害责任存在的问题，提出了相关立法建议：统一医疗损害责任鉴定制度，完善专家辅助人制度；实行举证责任缓和制度；建立医疗损害赔偿限额制度；增加医疗机构免责事由的情形；建立医疗损害责任保险制度；建立医疗损害责任纠纷仲裁制度，完善医疗纠纷调解制度。
[Abstract]:Medical damage liability is not only a hot issue of social concern, but also a difficult problem in tort liability law. It deeply reflects the game and compromise between doctors and patients. The particularity of medical behavior determines the difference between medical damage liability and other tort liability. Moreover, it is necessary to make a value trade-off between the long-term development of medical and health undertakings and the interests of all patients. The Tort liability Law unifies the concept of medical damage liability and ends the dualistic standard of compensation. It is of great significance to solve medical disputes. However, some problems have not been solved fundamentally. This paper starts with the concept of medical damage liability, and clarifies the nature of medical injury liability-from the point of view of helping to protect the legitimate rights and interests of patients, This paper expounds the legal basis of medical injury, points out the deficiency of medical damage liability system, and puts forward some suggestions to perfect the medical damage liability system. The text of the article is divided into four parts:. The first part is an overview of medical damage liability. Firstly, it defines medical malpractice and non-medical malpractice, then defines medical damage liability, and clarifies that the nature of medical damage liability is tort liability. Secondly, it expounds the concept and characteristics of medical behavior. The second part is the constitutive requirements of medical damage liability. This is the theoretical difficulty in this paper. Firstly, the principle of liability for medical damage is discussed, which is mainly based on the principle of fault liability, supplemented by the principle of presumption of fault and the principle of no fault. This paper expounds the constitutive elements of medical damage liability, that is, medical fault, damage fact, medical fault and damage fact, and discusses the criterion of medical fault, the scope of damage and the determination of causality. This paper introduces the reasons of exemption provided by Tort liability Law in our country, and analyzes the basis of exemption. Then, it defines the technical identification of medical accident and the judicial identification of medical fault, and clarifies the relationship between them. This paper investigates the distribution of burden of proof in medical injury litigation abroad, and expounds the legislative choice of burden of proof distribution in medical injury litigation of our country. The third part analyzes the deficiency of medical damage liability system. Although the Tort liability Law unifies the concept of medical damage liability, compensation standards, etc. However, there are still some problems in the present medical damage liability: the dualistic medical damage appraisal system is still unsolved, the distribution of the burden of proof is still not reasonable, the limitation system of medical damage compensation is not stipulated; The disclaimer of medical institution is not well defined, the medical liability insurance system is not stipulated, and the way to solve the dispute of medical damage compensation is not constructed. Part 4th is the suggestion to perfect the liability for medical injury. This is the foothold of this article. In view of the problems existing in the liability for medical injury, the author puts forward some legislative suggestions: unifying the system of medical damage liability appraisal and perfecting the system of expert assistant; Implement the system of easing the burden of proof; establish the limitation system of medical damages compensation; increase the circumstances of medical institutions exemption from liability; establish the medical damage liability insurance system; establish the arbitration system of medical damage liability disputes; improve the mediation system of medical disputes.
【学位授予单位】：新疆师范大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：D923.2

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