医疗损害案件中因果关系的认定
发布时间：2018-08-16 14:34
【摘要】：因果关系具有抽象性、复杂性的特点,医疗损害案件中的因果关系的认定,因为医疗行为的专业性、风险性、不确定的因素太多,使其认定比较困难。各国对因果关系理论研究也众说纷纭,我国采用的相当因果关系理论在实践中认定标准混乱,在实践中部分法官也没有结合相关理论对因果关系进行认定。当医患纠纷发生诉诸法律时,法官对医患双方因果关系的认定,绝大部分寄希望于医疗鉴定,我国现有的医疗鉴定体制还存在很大的问题,而法官又过分依赖医疗鉴定结论,按照一般举证责任分配原则,不能合理的分配医患双方的举证责任,加重了患者的负担,不能很好的维护患者的合法权益。尤其是在患者存在“治愈或者存活机会丧失”的情况下,我国现有的法律规定没有明确对机会利益的保护,患者很难证明治愈机会丧失与医方损害行为之间存在因果关系,患者的合法权益得不到保护,医患之间的矛盾加深,不利于医疗机构和医学事业的发展。我国医疗损害案件中因果关系的认定在理论和司法实践中都存在不少问题,比较相关国家在司法实践中对因果关系理论的运用,英美法系国家从事实和法律二层次认定因果关系的思维更清晰,值得借鉴。在分析二元制医疗鉴定体制存在的弊端的基础上,建议在立法上明确一个医疗鉴定体制,使因果关系的鉴定结论有统一的标准。在医疗损害案件中,一般侵权责任因果关系证明分配原则对于患者来说举证更加困难,在相关立法中应明确对医疗损害案件因果关系证明责任的分配制度,缓和患者的举证责任。同时也要在立法上明确对机会丧失利益的保护,更好的保护受害患者期待利益的损失。医疗损害案件中因果关系的认定是重中之重,必须从理论和司法实践两方面对其存在的问题进行分析完善。
[Abstract]:Causality has the characteristics of abstractness and complexity, and the identification of causality in medical injury cases, because of the professional, risk and uncertain factors of medical behavior, it is difficult to identify it. There are different opinions on causality theory in many countries. In practice, the relative causality theory used in our country is confused, and in practice some judges have not confirmed causality in combination with relevant theories. When doctor-patient disputes take place in law, most of the judges' determination of the causality between doctors and patients depends on medical expertise. There are still great problems in the existing medical appraisal system in our country, and the judges rely too much on the conclusion of medical expertise. According to the general principle of burden of proof, the burden of proof can not be reasonably distributed between doctors and patients, which increases the burden of patients and can not protect the legitimate rights and interests of patients. Especially in the case of "cure or loss of chance of survival" of patients, the existing laws and regulations of our country do not clearly protect the interests of opportunity. It is very difficult for patients to prove that there is a causal relationship between the loss of chance of cure and the damage behavior of doctors. The legitimate rights and interests of patients can not be protected and the contradiction between doctors and patients deepens, which is not conducive to the development of medical institutions and medical undertakings. There are many problems in the theory and judicial practice of causality in medical injury cases in our country. This paper compares the application of causality theory in judicial practice in related countries. Anglo-American legal system countries from the fact and the law two levels of thinking to identify causality more clear, worthy of reference. On the basis of analyzing the disadvantages of the two-element medical appraisal system, it is suggested that a medical appraisal system should be defined in legislation so that the conclusion of causality can be unified. In medical injury cases, it is more difficult for patients to prove the principle of causality distribution of general tort liability. In the relevant legislation, the distribution system of the burden of proof of causality in medical injury cases should be clearly defined. Ease the patient's burden of proof. At the same time, we should also legislate the protection of the opportunity loss, better protect the victims of the loss of interest. The determination of causality in medical injury cases is the most important one, so it is necessary to analyze and perfect the existing problems from the aspects of theory and judicial practice.
【学位授予单位】：南京师范大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：D923
[Abstract]:Causality has the characteristics of abstractness and complexity, and the identification of causality in medical injury cases, because of the professional, risk and uncertain factors of medical behavior, it is difficult to identify it. There are different opinions on causality theory in many countries. In practice, the relative causality theory used in our country is confused, and in practice some judges have not confirmed causality in combination with relevant theories. When doctor-patient disputes take place in law, most of the judges' determination of the causality between doctors and patients depends on medical expertise. There are still great problems in the existing medical appraisal system in our country, and the judges rely too much on the conclusion of medical expertise. According to the general principle of burden of proof, the burden of proof can not be reasonably distributed between doctors and patients, which increases the burden of patients and can not protect the legitimate rights and interests of patients. Especially in the case of "cure or loss of chance of survival" of patients, the existing laws and regulations of our country do not clearly protect the interests of opportunity. It is very difficult for patients to prove that there is a causal relationship between the loss of chance of cure and the damage behavior of doctors. The legitimate rights and interests of patients can not be protected and the contradiction between doctors and patients deepens, which is not conducive to the development of medical institutions and medical undertakings. There are many problems in the theory and judicial practice of causality in medical injury cases in our country. This paper compares the application of causality theory in judicial practice in related countries. Anglo-American legal system countries from the fact and the law two levels of thinking to identify causality more clear, worthy of reference. On the basis of analyzing the disadvantages of the two-element medical appraisal system, it is suggested that a medical appraisal system should be defined in legislation so that the conclusion of causality can be unified. In medical injury cases, it is more difficult for patients to prove the principle of causality distribution of general tort liability. In the relevant legislation, the distribution system of the burden of proof of causality in medical injury cases should be clearly defined. Ease the patient's burden of proof. At the same time, we should also legislate the protection of the opportunity loss, better protect the victims of the loss of interest. The determination of causality in medical injury cases is the most important one, so it is necessary to analyze and perfect the existing problems from the aspects of theory and judicial practice.
【学位授予单位】：南京师范大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：D923
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