中国医疗损害侵权案件举证责任分配的不足和解决方案

发布时间：2018-06-03 19:31

本文选题：医疗侵权 + 举证责任　；参考：《中国社会科学院研究生院》2015年硕士论文

【摘要】：在我国医患关系日益紧张、医疗侵权案件不断增加的大环境下,《中华人民共和国侵权责任法》(以下简称“《侵权责任法》”)彻底推翻了《最高人民法院关于民事诉讼证据的若干规定》(以下简称“《证据规则》”)中对医疗侵权案件举证责任的分配,从举证责任倒置恢复成了一般的举证责任。这既有其先进之处,也有值得商榷和探讨的地方。本文主要从以下几个方面分析我国对医疗侵权案件不同举证责任分配制度的优点和不足,并力争探讨、分析出一个适合于我国当前国情的解决方案。第一部分阐述了《证据规则》和《侵权责任法》对医疗侵权案件举证责任的不同规定。首先是《证据规则》规定的举证责任倒置制度存在的弊端。该段在总结了《侵权责任法》颁布前部分学者的观点,对弊端进行了总结,主要有四点:1.医方易举证不能,因立法原因处于诉讼的劣势地位;2.鼓励了恶意诉讼,导致医疗侵权案件激增;3.导致医方“防御型医疗”的增加;4.阻碍了医疗科学的发展。其次是《侵权责任法》对医疗侵权案件举证责任的修改,以及修改后的不足。在修改方面主要对比了颁布前后的差别所在。在修改后的不足方面,主要从法律规定内容的前后重复、逻辑混乱、因果关系证明责任缺失和医疗鉴定制度有缺陷这四个方面进行了分析。第二部分借鉴了大陆法系和英美法系法律制度较先进国家的优秀制度。主要包括德国的“表见证明”制度和“重大医疗过错的证明责任倒置”制度;日本的“大致推定”制度;法国对于医疗侵权案件的处理经验;英国的“勃拉姆”规则、“若无则不”规则以及美国的“流派分歧”原则。第三部分在第一、二部分分析的基础上,借鉴了第三部分的优秀制度,对我国目前的医疗侵权案件举证责任制度提出了建议。主要建议有以下五点:1.完善对过错的证明责任;2.明确对因果关系的证明责任;3.增加医方的医疗资料保管责任和提供责任;4.完善医疗鉴定制度;5.以较柔和的方式对现有制度进行修正和改善,如司法解释和指导案例的方式。最后一部分为本文的结论,结论中总结了本文的主要内容和主题思想,并提出了本文的不足和值得改进之处。
[Abstract]:In our country, the relationship between doctors and patients is increasingly tense. In the general environment of increasing medical tort cases, the Tort liability Law of the people's Republic of China (hereinafter referred to as "the Tort liability Law") has completely overturned the provisions of the Supreme people's Court on evidence in civil proceedings. The distribution of the burden of proof in medical tort cases, The inversion of the burden of proof has been restored to the general burden of proof. This not only has its advanced place, also has the place which is worth discussing and the discussion. This paper analyzes the advantages and disadvantages of different burden of proof distribution system in medical tort cases from the following aspects, and tries to explore a solution suitable for the current situation of our country. The first part expounds the different provisions of the rules of evidence and the Tort liability Law on the burden of proof in medical tort cases. The first is the malpractice of the inverted system of burden of proof stipulated in the rules of evidence. This section summarizes the views of some scholars before the promulgation of the Tort liability Law, and summarizes the disadvantages, mainly four points: 1. The doctor is easy to prove that cannot, because of legislation reason is in the inferior position of litigation 2. Encouraged malicious litigation, leading to a proliferation of medical infringement cases. This has led to an increase in defensive medical care. It hinders the development of medical science. Secondly, the tort liability law modifies the burden of proof in medical tort cases, and the deficiency. In the aspect of revision, the difference between before and after promulgation is compared. In the aspect of deficiency after revision, this paper mainly analyzes four aspects: the repetition of legal provisions, the confusion of logic, the lack of causality burden of proof and the defect of medical appraisal system. The second part draws lessons from the excellent system of civil law system and Anglo-American legal system. It mainly includes the system of "apparent proof" and "inversion of burden of proof" in Germany; the system of "approximate presumption" in Japan; the experience of France in dealing with cases of medical tort; and the rules of "Bram" in Britain. The rule of "if nothing is not" and the "school difference" principle of the United States. Based on the analysis of the first and second parts, the third part draws lessons from the excellent system of the third part, and puts forward some suggestions on the present system of burden of proof in medical tort cases in our country. The main suggestions are as follows: 5: 1. Perfect the burden of proof of fault. Make clear the burden of proof of causality. Increase the medical data custody responsibility and provide responsibility. Perfecting the Medical Appraisal system. To amend and improve the existing system in a softer way, such as judicial interpretation and guidance of cases. The last part is the conclusion of this paper, which summarizes the main contents and main ideas of this paper, and puts forward the shortcomings and worthy of improvement.
【学位授予单位】：中国社会科学院研究生院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：D923

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