医疗损害鉴定制度“一元化”改革设计

发布时间：2018-09-11 17:34

【摘要】：最高人民法院2003年下发的《关于参照医疗事故处理条例审理医疗纠纷民事案件的通知》,将医疗损害赔偿分为医疗事故、非医疗事故损害赔偿,医疗纠纷案件诉由、适用法律、审理程序、赔偿数额计算的"二元化"标准由此确立。《侵权责任法》统一了医疗损害纠纷案件诉由和法律适用,但延续了鉴定机构、鉴定模式的"二元化"。当事人常倾向性选择对己有利的鉴定机构,因鉴定机构不同结论出现差异甚至冲突屡见不鲜,浪费了诉讼资源,也使当事人不能及时得到法律救济。当前,对医疗损害鉴定"一元化"改革方向已形成共识,但对实现"一元化"的具体路径仍有分歧。故本文对医疗事故技术鉴定与医疗过错司法鉴定两种主要鉴定模式进行了全面比较,提出以医疗事故技术鉴定为模板,保持其医学专业性优势,同时吸收医疗过错司法鉴定优点,完善机制、程序,在不改变现有两类鉴定机构隶属关系、主管部门的前提下,建立"一纵两横"新型鉴定制度,即在统一的鉴定规则下,允许医学会和司法鉴定机构独立实施鉴定,希望提供有价值的改革参考。除导言和结语外,本文分为五部分。第一部分讨论了 "医疗损害鉴定"的概念,从医疗事故技术鉴定视角梳理了我国医疗纠纷鉴定制度,肯定了 "二元化"鉴定的合理性,也对其弊端进行了分析。第二部分从理论和实证角度,对两种鉴定模式进行全面比较和分析。第三部分介绍了不同国家(地区)的鉴定制度,提出了我国医疗损害鉴定制度"一元化"改革方案,分析了医疗事故技术鉴定的合法性问题。第四、第五部分从实体、程序角度提出了具体建议。
[Abstract]:A notice issued by the Supreme people's Court in 2003 concerning the trial of civil cases concerning medical disputes with reference to the regulations on handling Medical malpractice, classifying the compensation for medical damages into medical malpractice, non-medical malpractice damages, and the cause of medical dispute cases, and applying the law, The standard of "dualization" of calculating the amount of compensation is established. The Tort liability Law unifies the cause of litigation and the application of the law in cases of medical injury dispute, but it continues the "dualization" of the appraisal institution and the appraisal mode. The parties often prefer to choose the appraisal institution which is beneficial to themselves, because of the differences and even conflicts among the different conclusions of the appraisal organization, the litigant resources are wasted and the litigants can not get the legal remedy in time. At present, a consensus has been formed on the reform direction of "unitization" of medical injury appraisal, but there are still differences on the specific way to realize "unitization". Therefore, this paper makes a comprehensive comparison between the technical identification of medical malpractice and the judicial identification of medical fault, and puts forward that the technical identification of medical malpractice should be taken as a template to maintain its superiority in medical specialty. At the same time, we should absorb the advantages of judicial identification of medical fault, perfect the mechanism and procedures, and establish a new appraisal system of "one vertical, two horizontal" without changing the subordinate relationship between the existing two types of appraisal institutions and the competent departments, that is, under the unified appraisal rules, To allow medical associations and forensic institutions to carry out independent accreditation, hoping to provide valuable reference for reform. In addition to the introduction and conclusion, this article is divided into five parts. The first part discusses the concept of "medical injury appraisal", combs the medical dispute appraisal system from the medical malpractice technical appraisal angle, affirms the rationality of "dualistic" appraisal, and analyzes its malpractice. The second part makes a comprehensive comparison and analysis of the two identification models from the theoretical and empirical perspectives. The third part introduces the appraisal system of different countries (regions), puts forward the "unified" reform scheme of medical damage appraisal system in China, and analyzes the legality of technical identification of medical malpractice. Fourth, the fifth part from the entity, the procedure angle proposed the concrete proposal.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：D922.16

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