【摘要】：因果關(guān)系具有抽象性、復(fù)雜性的特點(diǎn),醫(yī)療損害案件中的因果關(guān)系的認(rèn)定,因?yàn)獒t(yī)療行為的專業(yè)性、風(fēng)險性、不確定的因素太多,使其認(rèn)定比較困難。各國對因果關(guān)系理論研究也眾說紛紜,我國采用的相當(dāng)因果關(guān)系理論在實(shí)踐中認(rèn)定標(biāo)準(zhǔn)混亂,在實(shí)踐中部分法官也沒有結(jié)合相關(guān)理論對因果關(guān)系進(jìn)行認(rèn)定。當(dāng)醫(yī)患糾紛發(fā)生訴諸法律時,法官對醫(yī)患雙方因果關(guān)系的認(rèn)定,絕大部分寄希望于醫(yī)療鑒定,我國現(xiàn)有的醫(yī)療鑒定體制還存在很大的問題,而法官又過分依賴醫(yī)療鑒定結(jié)論,按照一般舉證責(zé)任分配原則,不能合理的分配醫(yī)患雙方的舉證責(zé)任,加重了患者的負(fù)擔(dān),不能很好的維護(hù)患者的合法權(quán)益。尤其是在患者存在“治愈或者存活機(jī)會喪失”的情況下,我國現(xiàn)有的法律規(guī)定沒有明確對機(jī)會利益的保護(hù),患者很難證明治愈機(jī)會喪失與醫(yī)方損害行為之間存在因果關(guān)系,患者的合法權(quán)益得不到保護(hù),醫(yī)患之間的矛盾加深,不利于醫(yī)療機(jī)構(gòu)和醫(yī)學(xué)事業(yè)的發(fā)展。我國醫(yī)療損害案件中因果關(guān)系的認(rèn)定在理論和司法實(shí)踐中都存在不少問題,比較相關(guān)國家在司法實(shí)踐中對因果關(guān)系理論的運(yùn)用,英美法系國家從事實(shí)和法律二層次認(rèn)定因果關(guān)系的思維更清晰,值得借鑒。在分析二元制醫(yī)療鑒定體制存在的弊端的基礎(chǔ)上,建議在立法上明確一個醫(yī)療鑒定體制,使因果關(guān)系的鑒定結(jié)論有統(tǒng)一的標(biāo)準(zhǔn)。在醫(yī)療損害案件中,一般侵權(quán)責(zé)任因果關(guān)系證明分配原則對于患者來說舉證更加困難,在相關(guān)立法中應(yīng)明確對醫(yī)療損害案件因果關(guān)系證明責(zé)任的分配制度,緩和患者的舉證責(zé)任。同時也要在立法上明確對機(jī)會喪失利益的保護(hù),更好的保護(hù)受害患者期待利益的損失。醫(yī)療損害案件中因果關(guān)系的認(rèn)定是重中之重,必須從理論和司法實(shí)踐兩方面對其存在的問題進(jìn)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.
【學(xué)位授予單位】：南京師范大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：D923

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本文編號：2186269