论我国现行的医疗损害鉴定制度

发布时间：2019-01-21 12:50

【摘要】：随着我国医疗体制不断的深入发展，与之相配套的医疗损害鉴定制度也在不断的改进和完善。1987年国务院颁布并实施了《医疗事故处理办法》（以下简称《办法》），标志着我国医疗纠纷鉴定体制由此建立，该体制确定了在处理医疗损害纠纷时以卫生行政部门做出的医疗事故鉴定为唯一依据，但其行政性的“一元制”鉴定模式具有严重的行业保护色彩，且越来越不能满足实际需要。为了解决《办法》带来的矛盾和压力，2002年,国务院颁布《医疗事故处理条例》（以下简称《条例》），由于该《条例》存在的弊端，司法实践中将医疗损害鉴定以“医疗事故”为界，划分为医疗事故技术鉴定及法医类司法鉴定，而由此形成了“二元制”鉴定模式。在现行的二元制鉴定模式的基础上，新颁布的《侵权责任法》第七章中关于医疗损害的规定虽解决了先前及当今医疗损害方面的诸多法律问题，但因《侵权责任法》为实体法，属私法范畴，不能对鉴定启动以及鉴定模式的选择等涉及公法问题作出规定，故《侵权责任法》并没有对处理医疗损害纠纷中采用何种鉴定方式作出明确规定。《侵权责任法》已实施三年之久，相关的司法解释仍未出台，我国解决医疗纠纷的“二元制”鉴定模式仍未有所改变，且还将在一定时期内继续存在，这不仅给医患委托、鉴定实行和司法实践带来了空前的难度和挑战，也使医患矛盾愈演愈烈，不利于医患纠纷的解决。本文通过对我国医疗损害鉴定相关制度的演进、适用、比较来剖析我国现行医疗损害鉴定制度在司法实践中存在的问题，在此基础上提出重建我国医疗损害鉴定制度的对策，，以此更好的解决医患矛盾，维护医疗秩序，促进社会和谐发展。本文共分四章。第一章从我国医疗损害鉴定制度的历史沿革入手，分析我国医疗损害鉴定制度，从《医疗事故处理办法》时期至《医疗事故处理条例》时期，到《侵权责任法》颁布后各个时期的特点及发展演变；第二章通过对我国各个时期医疗损害鉴定制度的分析，总结出当前医疗损害鉴定制度在司法实践中存在的问题；第三章虽然司法实践中我国医疗损害鉴定制度存在诸多问题，但在实践中达成的共识也具有借鉴意义；第四章在通过对我国医疗损害鉴定制度在司法实践中存在的问题分析及对司法实践中基本共识的借鉴，提出重建我国医疗损害鉴定制度的对策。
[Abstract]:With the continuous development of medical system in China, the corresponding medical damage appraisal system is constantly improved and perfected. In 1987, the State Council promulgated and implemented the "measures for handling Medical malpractice" (hereinafter referred to as "the measures"). This marks the establishment of a medical dispute appraisal system in China, which determines that the medical malpractice appraisal made by the health administrative department is the only basis for handling medical injury disputes. But its administrative "monistic system" appraisal mode has serious industry protection color, and more can not meet the actual needs. In order to solve the contradictions and pressures brought about by the "methods", in 2002, the State Council promulgated the regulations on handling Medical malpractice (hereinafter referred to as "the regulations"). In judicial practice, medical injury identification is divided into technical identification of medical malpractice and forensic identification, which is divided into "medical malpractice" and "dualistic system". On the basis of the current dualistic appraisal model, the provisions on medical injury in Chapter 7 of the newly promulgated Tort liability Law have solved many legal problems in medical injury before and today, but the Tort liability Law is a substantive law. Under the category of private law, it is not possible to regulate the initiation of appraisal and the choice of identification mode, which involve public law issues. Therefore, the Tort liability Law has not made a clear provision on how to deal with medical injury disputes. The Tort liability Law has been in force for three years, and the relevant judicial interpretation has not yet been issued. The "dualistic system" appraisal mode for solving medical disputes in our country has not been changed, and it will continue to exist in a certain period of time, which not only brings unprecedented difficulty and challenge to doctors and patients, but also brings unprecedented difficulties and challenges to the practice of appraisal and judicial practice. It also makes the contradiction between doctors and patients become more and more serious, which is not conducive to resolving the disputes between doctors and patients. Through the evolution, application and comparison of the relevant systems of medical injury identification in China, this paper analyzes the problems existing in the judicial practice of the current medical injury appraisal system in China, and then puts forward some countermeasures for rebuilding the medical injury appraisal system in China. In order to better solve the contradiction between doctors and patients, maintain the medical order, promote the harmonious development of society. This paper is divided into four chapters. The first chapter begins with the historical evolution of medical injury appraisal system in China, and analyzes the medical damage identification system in China, from the period of "measures for handling Medical malpractice" to the period of "regulations on treatment of Medical malpractice". The characteristics and evolution of each period after the promulgation of the Tort liability Law; The second chapter summarizes the problems existing in the current medical injury appraisal system in judicial practice through the analysis of the medical injury appraisal system in various periods of our country. The third chapter, although there are many problems in the judicial practice of medical injury appraisal system, but the consensus reached in practice also has reference significance; In the fourth chapter, through the analysis of the problems existing in the judicial practice of medical injury appraisal system in our country and the reference to the basic consensus in the judicial practice, the author puts forward the countermeasures to rebuild the medical injury appraisal system in our country.
【学位授予单位】：辽宁师范大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：D922.16;D923

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