论医疗服务的法律风险：《中华人民共和国侵权责任法》与普通法之比较

发布时间：2018-08-04 22:03

【摘要】：论文主要探讨医疗机构在《中华人民共和国侵权责任法》(侵权责任法)落实之后的法律风险问题。当看病难,看病贵的医疗问题无法得以缓和与解决,该法的有效性也就再次成为热门的焦点议题。就看病难的问题而言,它是一个医疗资源分配的问题。只要政府能够增加并提升现有的医疗资源,看病难的问题是有望解决的。至于看病贵的问题,它是以较为复杂的问题。除了市场的供给,物价的攀升以及医疗技术的进步等因素以外,医疗机构所需承受的法律风险也是造成看病贵问题的重要因素之一。然而,国内外对于法律风险与看病贵之间的关系之研究实属罕见。为了弥补这方面的欠缺,论文将着重于研究法律风险与看病贵的关系,并通过检验《侵权责任法》内有关医疗服务的条文,探讨该法落实后对于解决看病贵问题是否产生正面的影响。比较的方法基本上可被分为两大类:同类比较以及异类比较。论文认为同类比较的方法一般无法凸显问题的实质性与根本性。因此,论文选择了异类比较作为研究法律风险的方式。为此,论文选择了普通法与《侵权责任法》做比较。事实上,将医疗机构在《侵权责任法》下所需面对的法律风险与普通法作比较的做法,实属首次。众所周知,风险与成本是相辅相成的。论文坚信若是医疗机构的法律风险能够减低,在综合各方的努力下,看病贵的问题,最终将有望得以缓和与解决。宏观而言,有两方面关于医疗服务的本质是需要给予适当的关注的;第一,医疗结果的非绝对性,以及第二,医患之间的关系是属于诚信关系。就中国医疗服务的法律风险主要是因三个重要因素所造成的。第一,它是始于法律与司法制度过于保护患者利益的结果。这个结论主要是基于医疗机构在民事诉讼中必须承担过于沉重的举证责任的规定。尽管保护患者利益是无可厚非的做法,可是医疗机构也应当享有适当的法律保护。第二,由于《侵权责任法》对于有关医疗服务法律的不确定性以及局限性,因而无法有效地控制医疗机构的法律风险。这个看法是基于该法在多个有关医疗服务的条文中皆无法有效地确定审理医疗过失的标准与对于举证标准的要求。第三,司法体制对于医患纠纷判决的不一致性。中国法院的一些判例显示,一旦出现医患纠纷,医疗机构所可能面对的结局有三大类:第一类是过错责任类,第二类是在调解下的双赢类;以及第三类是无过错类。按照这个逻辑,论文首先探讨法律风险的因果关系,中国与普通法有关医疗服务法律与判例的法律背景,后将《侵权责任法》与普通法做各方面比较,其中包括过错责任的承担问题,咨询与告知义务,举证问题,免责条款,紧急情况的问题,隐私权,医疗产品责任,以及不可抗力问题。最后,论文以提出《侵权责任法》有关医疗服务的条文修正作为总结。
[Abstract]:This paper mainly discusses the legal risks of medical institutions after the implementation of the Tort liability Law of the people's Republic of China. When medical treatment is difficult and expensive medical problems can not be alleviated and solved, the effectiveness of the law becomes a hot issue again. As far as the difficulty of seeing a doctor is concerned, it is a problem of allocation of medical resources. As long as the government can increase and increase the existing medical resources, the problem is expected to be resolved. As for the expensive problem of seeing a doctor, it is a more complicated problem. In addition to the market supply, rising prices and advances in medical technology and other factors, medical institutions have to bear the legal risk is also one of the important factors that cause the problem of expensive medical treatment. However, research on the relationship between legal risk and expensive medical treatment is rare at home and abroad. In order to make up for this deficiency, the paper will focus on the relationship between legal risk and expensive medical treatment, and pass the examination of the provisions of the Tort liability Law on medical services. This paper discusses whether the implementation of this law has a positive effect on solving the problem of expensive medical treatment. Comparison methods can be basically divided into two categories: similar comparison and heterogeneity comparison. The paper thinks that the method of similar comparison can not highlight the substance and essence of the problem. Therefore, the paper chooses the heterogeneity comparison as the way to study the legal risk. Therefore, the paper chooses the common law and Tort liability Law to make a comparison. In fact, it is the first time to compare the legal risks faced by medical institutions under the Tort liability Act with the common law. As we all know, risk and cost complement each other. The paper firmly believes that if the legal risk of medical institutions can be reduced, with the efforts of all parties, the problem of expensive medical treatment will hopefully be alleviated and solved. Macroscopically, there are two aspects about the nature of medical service that need to be given due attention. First, the medical outcome is not absolute, and second, the relationship between doctors and patients belongs to the relationship of good faith. The legal risk of Chinese medical service is mainly caused by three important factors. First, it is the result of the fact that the legal and judicial systems are too protective of the interests of patients. This conclusion is mainly based on the requirement that medical institutions bear too heavy burden of proof in civil proceedings. While it is fair to protect the interests of patients, medical institutions should also enjoy adequate legal protection. Second, due to the uncertainty and limitation of the tort liability law, the legal risks of medical institutions cannot be effectively controlled. This view is based on the fact that the Act is unable to effectively determine the standard of adjudication of medical negligence and the standard of proof in several articles on medical services. Thirdly, the judicial system is inconsistent with the adjudication of doctor-patient disputes. Some cases of Chinese courts show that once there are doctor-patient disputes, medical institutions may face the outcome of three major categories: the first type is the category of fault liability, the second category is the win-win category under mediation; and the third category is the category of no-fault. According to this logic, the thesis first discusses the causality of legal risk, the legal background of medical service law and case law between China and the common law, and then compares the tort liability law with the common law. These include the assumption of fault liability, the obligation to consult and inform, the burden of proof, the exemption clause, the emergency, the right to privacy, the liability for medical products, and the issue of force majeure. Finally, the article proposes the tort liability law about the medical service article amendment as the summary.
【学位授予单位】：对外经济贸易大学
【学位级别】：博士
【学位授予年份】：2015
【分类号】：D923

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