本文關(guān)鍵詞： 醫(yī)療過錯 不確定性 一般標(biāo)準(zhǔn) 注意義務(wù) 舉證緩和　出處：《西南政法大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：在當(dāng)前形勢下,醫(yī)患矛盾已成為社會的熱點問題之一,有關(guān)醫(yī)患糾紛的案件數(shù)量也不斷攀升,其在法院審理案件中占了很大一部分比重。法院在解決醫(yī)療糾紛的案件時,主要是以醫(yī)方是否存在“醫(yī)療過錯”為中心進行審理。對“醫(yī)療過錯”的把握不僅決定著醫(yī)療糾紛能否公平、公正的解決,還對維護雙方的利益,尤其是弱勢一方的利益更能得到極大保護。然而,自從《侵權(quán)責(zé)任法》頒布實施以來,醫(yī)患矛盾得到很大的改善,但醫(yī)療侵權(quán)仍然在理論和實踐中存在些許不足。醫(yī)療過錯是醫(yī)療損害責(zé)任的核心構(gòu)成要件,但對醫(yī)療過錯的認定不能達成理論上的一致性。醫(yī)療過錯認定在理論上的不確定性和模糊性,很可能會阻礙實踐中醫(yī)療沖突的解決,在一定程度上反而會加劇醫(yī)療糾紛。理論最終是應(yīng)用于實踐的,為了更好地解決患者和醫(yī)方的矛盾,做到最大程度的利益維護,十分有必要對醫(yī)療過錯進行深入的探討,全面去把握醫(yī)療過錯,對醫(yī)療過錯作出明確的認定,這正是寫作此文的最終目的。本文主要從三部分詳細探討了有關(guān)醫(yī)療過錯的認定和證明:第一部分主要分析了醫(yī)療過錯認定的一般標(biāo)準(zhǔn),醫(yī)療過錯的一般認定標(biāo)準(zhǔn)屬于抽象標(biāo)準(zhǔn),對于這一部分,目前學(xué)術(shù)界仍未達成以一致意見,筆者在本部分充分分析了目前我國對醫(yī)療過錯一般認定標(biāo)準(zhǔn)的情況。先從過錯的認識再過渡到醫(yī)療過錯,并結(jié)合《侵權(quán)責(zé)任法》的第“54”條、“57”條“58”條的相關(guān)規(guī)定以及國外對醫(yī)療過錯抽象認定標(biāo)準(zhǔn)的情況進行了具體分析,提出了對“當(dāng)時診療水平”要綜合各種因素進行判定,不能單一認定的觀點。第二部分主要介紹了醫(yī)療過錯的具體認定標(biāo)準(zhǔn),醫(yī)療“注意義務(wù)”作為醫(yī)療過失的具體認定標(biāo)準(zhǔn),首先,筆者引用了小案例對概念進行了相關(guān)解釋,重點研討了如何認定醫(yī)療注意義務(wù)以及醫(yī)療注意義務(wù)的例外情況;而且還針對當(dāng)前認定“醫(yī)療注意義務(wù)”的復(fù)雜情況,提出對其認定要先看有無醫(yī)療注意能力。本部分采用了定性分析法,全方位統(tǒng)籌把握醫(yī)療注意義務(wù)。另外,為了做到理論與實踐相結(jié)合,還采用典型案例詳細說明了認定醫(yī)療過失的過程。除此之外,筆者對幾種特殊情形探討了其是否屬于違反醫(yī)療注意義務(wù),并說明了自己的理由與看法。最后針對醫(yī)療注意義務(wù)內(nèi)容的概括化,主張要將其細化。第三部分內(nèi)容是有關(guān)醫(yī)療過錯的證明,包括診療過錯的證明責(zé)任、組織性過錯的證明責(zé)任;對其舉證,筆者主張采取一般歸責(zé),即“誰主張誰舉證;在難以舉證的特殊情況下,筆者建議采用舉證責(zé)任轉(zhuǎn)移制度和舉證責(zé)任緩和制度。另外分析了醫(yī)療鑒定機制的不足,并提出要建立統(tǒng)一的醫(yī)療鑒定機構(gòu)。
[Abstract]:Under the current situation, the contradiction between doctors and patients has become one of the hot issues in the society, and the number of doctor-patient disputes has also been increasing, which accounts for a large proportion of the cases tried by the court. When the court resolves the cases of medical disputes, It is mainly about whether the medical side has a "medical fault" as the center of the trial. The assurance of the "medical fault" not only determines whether the medical dispute can be resolved fairly and fairly, but also protects the interests of both sides. In particular, the interests of vulnerable parties can be greatly protected. However, since the enactment and implementation of the Tort liability Law, the doctor-patient contradictions have been greatly improved. However, there are still some deficiencies in the theory and practice of medical tort. Medical fault is the core component of medical damage liability. However, the identification of medical fault can not reach theoretical consistency. The uncertainty and ambiguity of medical fault identification in theory may hinder the solution of medical conflict in practice. On the contrary, to some extent, medical disputes will be aggravated. The theory is finally applied to practice. In order to better solve the contradiction between patients and doctors and to maintain the interests to the greatest extent, it is very necessary to deeply discuss medical mistakes. To comprehensively grasp the medical fault, to make a clear determination of the medical fault, This is the ultimate purpose of writing this article. This paper discusses the identification and proof of medical fault in detail from three parts: the first part mainly analyzes the general standards of medical fault identification. The general standard of medical fault is an abstract standard, for this part of the academic community has not yet reached a consensus, In this part, the author makes a full analysis of the current situation of the general standard of medical fault in our country. First of all, from the understanding of fault to the transition to medical fault, Combined with the relevant provisions of "54", "57" and "58" of the Tort liability Law, as well as the foreign abstract identification standard of medical fault, this paper makes a concrete analysis, and puts forward that the "level of diagnosis and treatment at that time" should be judged by various factors. The second part mainly introduces the specific identification standard of medical fault, medical "duty of care" as the specific identification standard of medical negligence. First, the author cited a small case to explain the concept. Focusing on how to identify the duty of medical care and the exceptions to the duty of care, and also focusing on the complex situation of recognizing the duty of care. In this part, the qualitative analysis method is used to grasp the duty of care in all aspects. In addition, in order to combine theory with practice, In addition, the author discusses whether the medical negligence is in violation of the duty of care in several special cases. Finally, aiming at the generalization of the content of the duty of medical care, the author argues that it should be refined. The third part is about the proof of the medical fault, including the burden of proof of the fault of diagnosis and treatment. The burden of proof of the organizational fault; for its proof, the author advocates to adopt general imputation, that is, "who claims to prove the burden of proof; under the special circumstances where the proof is difficult to prove," The author suggests to adopt the system of transferring the burden of proof and the system of easing the burden of proof. In addition, this paper analyzes the deficiency of the medical appraisal mechanism and puts forward the establishment of a unified medical appraisal institution.
【學(xué)位授予單位】：西南政法大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：D923

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