医患纠纷法医学鉴定与医学鉴定程序之比较研究

发布时间：2018-02-12 02:47

本文关键词： 医患纠纷法医学鉴定医学鉴定医疗事故医疗纠纷程序　出处：《华东政法大学》2008年硕士论文　论文类型：学位论文

【摘要】： 医疗体制改革中,我国的医患纠纷呈现上升趋势,并不断激化。有关医疗纠纷的争议日渐增多,其中相当一部分最终进入诉讼程序。在医疗纠纷的解决过程中,有关医疗事故的鉴定成为其中争议很大的一个环节。1987年制定的《医疗事故处理办法》将组织医疗事故技术鉴定的机构设定为医疗事故技术鉴定委员会,并规定医疗事故技术鉴定是医疗纠纷诉讼的前置程序,引起很大争议。2002年9月1日开始实施的《医疗事故处理条例》废止了《医疗事故处理办法》,规定医疗事故技术鉴定由中立的医学会负责组织实施,医学会建立专家库,聘请本行政区域内符合条件的医学专家进入专家库作为鉴定候选人,采取由双方当事人在医学会的组织下随机抽取专家组成专家鉴定组的方法对医疗事故进行鉴定,在一定程度上改变了由医疗事故技术鉴定委员会对医疗事故进行鉴定的不公正性,缓和了医患之间关于鉴定的矛盾和纠纷。但是,随着《条例》的实施,实践中又出现了新的问题。针对《条例》中规定不明确的地方,最高人民法院出台了相关的司法解释,规定在诉讼中遇到涉及医疗事故技术鉴定时,人民法院应当委托具有受理资格的医学会进行鉴定;对医疗事故之外的其他医疗纠纷,由人民法院委托列入名册的司法鉴定机构进行鉴定。医疗事故鉴定和医疗事故以外的其他医疗纠纷的鉴定由不同的鉴定机构组织,以及按《医疗事故处理条例》和民法中有关人身损害案件的赔偿标准、计算方法和数额的差异,使得实践中出现当事人避开医疗事故鉴定和处理程序而选择医疗纠纷损害赔偿诉讼和医疗纠纷司法鉴定;或者在诉讼中经医疗事故的两级鉴定后重新启动司法鉴定程序的情况。这样,在有关医疗事故的民事赔偿诉讼中,重新鉴定的次数得不到控制,医学鉴定实际上被规避,诉讼效率降低,当事人的诉讼负担在一定程度上也有所加重。本文拟通过对医患纠纷法医学鉴定和医学鉴定程序的比较,从鉴定人的选择、鉴定的标准和依据、鉴定的具体程序、鉴定结论的形式等方面出发,寻求两种鉴定程序的异同,并进一步提出司法鉴定机构介入诉讼中医疗事故鉴定的设想,将司法鉴定作为与医学鉴定并行的程序,由当事人自由选择,从而赋予当事人对程序的选择权,改变目前诉讼中医学会专属鉴定的现状,从程序正义满足当事人对实体公正的要求。同时,通过两种程序的比较,对司法鉴定机构开展医学鉴定的不足和缺陷作一探讨,并完善司法鉴定机构开展医疗事故鉴定的程序,为通过诉讼程序及时解决医患纠纷提出新的设想,以解决目前医疗纠纷民事赔偿诉讼中的一些矛盾。
[Abstract]:In the reform of the medical system, the doctor-patient disputes in our country are on the rise, and they are becoming more and more intense. The disputes about medical disputes are increasing day by day, and quite a few of them are finally entered into the litigation procedure. In the process of resolving medical disputes, The appraisal of medical malpractice has become one of the most controversial links. In 1987, the "measures for handling Medical malpractice" set the organization that organizes the technical appraisal of medical malpractice as the Technical Appraisal Committee of Medical malpractice. It also stipulates that technical identification of medical malpractice is the leading procedure in medical dispute litigation. The regulations on the handling of Medical Accidents, which came into effect in September 1st 2002, abolished the measures for handling Medical Accidents, and stipulated that the technical appraisal of medical accidents shall be organized and implemented by the neutral medical association, and the medical association shall establish a pool of experts. Inviting qualified medical experts in their respective administrative areas to enter the expert pool as an expert candidate, and using the method of randomly selecting experts from both parties under the organization of the medical association to form an expert appraisal group for the identification of medical accidents, To a certain extent, it has changed the unfairness of medical malpractice identification by the Medical accident Technical Appraisal Committee and alleviated the contradictions and disputes between doctors and patients regarding the appraisal. However, with the implementation of the regulations, In practice, new problems have arisen. In view of the unclear provisions in the regulations, the Supreme people's Court has issued relevant judicial interpretations, stipulating that when technical identification of medical malpractice is involved in the proceedings, The people's court shall entrust a medical association with the qualification of accepting medical affairs to conduct an appraisal; and in the case of any medical dispute other than a medical accident, The people's court shall entrust the judicial expert institutions on the roster to conduct the appraisal. The identification of medical malpractice and other medical disputes other than medical malpractice shall be organized by different appraisal institutions, As well as the differences in compensation standards, calculation methods and amounts for personal injury cases in accordance with the regulations on handling Medical malpractice and the Civil Law, In practice, the parties avoid the medical malpractice identification and processing procedures and choose medical dispute damages litigation and medical dispute judicial identification; Or the case of restarting the judicial identification procedure after the two-level appraisal of a medical accident in a lawsuit. In this way, in the civil compensation proceedings relating to a medical accident, the number of reappraisals cannot be controlled, and the medical expertise is actually circumvented. The litigation efficiency is reduced, and the litigant's litigation burden is also increased to some extent. This paper intends to compare the forensic medical identification and medical identification procedures of doctor-patient disputes, from the selection of experts, the criteria and the basis of identification. Proceeding from the specific procedure and the form of the appraisal conclusion, this paper seeks the similarities and differences between the two kinds of identification procedures, and further puts forward the assumption of medical malpractice identification in the intervention of the judicial expertise institution in the litigation. Judicial expertise is regarded as a parallel procedure with medical expertise, which is freely chosen by the parties, thus giving the parties the right to choose the procedure and changing the current situation of the exclusive identification of the Chinese Medicine Society of Litigation. From procedural justice to meet the parties' requirements for substantive justice. At the same time, through the comparison of the two procedures, this paper probes into the deficiencies and defects of medical identification in judicial expertise institutions, and perfects the procedures of medical malpractice identification in judicial expertise institutions. In order to solve the doctor-patient dispute timely through the lawsuit procedure, this paper puts forward a new idea to solve some contradictions in the civil compensation lawsuit of the medical dispute.
【学位授予单位】：华东政法大学
【学位级别】：硕士
【学位授予年份】：2008
【分类号】：D919.4

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