發(fā)布時(shí)間：2018-02-12 02:47

  本文關(guān)鍵詞： 醫(yī)患糾紛法醫(yī)學(xué)鑒定 醫(yī)學(xué)鑒定 醫(yī)療事故 醫(yī)療糾紛 程序　出處：《華東政法大學(xué)》2008年碩士論文　論文類型：學(xué)位論文

【摘要】： 醫(yī)療體制改革中,我國(guó)的醫(yī)患糾紛呈現(xiàn)上升趨勢(shì),并不斷激化。有關(guān)醫(yī)療糾紛的爭(zhēng)議日漸增多,其中相當(dāng)一部分最終進(jìn)入訴訟程序。在醫(yī)療糾紛的解決過(guò)程中,有關(guān)醫(yī)療事故的鑒定成為其中爭(zhēng)議很大的一個(gè)環(huán)節(jié)。1987年制定的《醫(yī)療事故處理辦法》將組織醫(yī)療事故技術(shù)鑒定的機(jī)構(gòu)設(shè)定為醫(yī)療事故技術(shù)鑒定委員會(huì),并規(guī)定醫(yī)療事故技術(shù)鑒定是醫(yī)療糾紛訴訟的前置程序,引起很大爭(zhēng)議。2002年9月1日開(kāi)始實(shí)施的《醫(yī)療事故處理?xiàng)l例》廢止了《醫(yī)療事故處理辦法》,規(guī)定醫(yī)療事故技術(shù)鑒定由中立的醫(yī)學(xué)會(huì)負(fù)責(zé)組織實(shí)施,醫(yī)學(xué)會(huì)建立專家?guī)?聘請(qǐng)本行政區(qū)域內(nèi)符合條件的醫(yī)學(xué)專家進(jìn)入專家?guī)熳鳛殍b定候選人,采取由雙方當(dāng)事人在醫(yī)學(xué)會(huì)的組織下隨機(jī)抽取專家組成專家鑒定組的方法對(duì)醫(yī)療事故進(jìn)行鑒定,在一定程度上改變了由醫(yī)療事故技術(shù)鑒定委員會(huì)對(duì)醫(yī)療事故進(jìn)行鑒定的不公正性,緩和了醫(yī)患之間關(guān)于鑒定的矛盾和糾紛。但是,隨著《條例》的實(shí)施,實(shí)踐中又出現(xiàn)了新的問(wèn)題。針對(duì)《條例》中規(guī)定不明確的地方,最高人民法院出臺(tái)了相關(guān)的司法解釋,規(guī)定在訴訟中遇到涉及醫(yī)療事故技術(shù)鑒定時(shí),人民法院應(yīng)當(dāng)委托具有受理資格的醫(yī)學(xué)會(huì)進(jìn)行鑒定;對(duì)醫(yī)療事故之外的其他醫(yī)療糾紛,由人民法院委托列入名冊(cè)的司法鑒定機(jī)構(gòu)進(jìn)行鑒定。醫(yī)療事故鑒定和醫(yī)療事故以外的其他醫(yī)療糾紛的鑒定由不同的鑒定機(jī)構(gòu)組織,以及按《醫(yī)療事故處理?xiàng)l例》和民法中有關(guān)人身?yè)p害案件的賠償標(biāo)準(zhǔn)、計(jì)算方法和數(shù)額的差異,使得實(shí)踐中出現(xiàn)當(dāng)事人避開(kāi)醫(yī)療事故鑒定和處理程序而選擇醫(yī)療糾紛損害賠償訴訟和醫(yī)療糾紛司法鑒定;或者在訴訟中經(jīng)醫(yī)療事故的兩級(jí)鑒定后重新啟動(dòng)司法鑒定程序的情況。這樣,在有關(guān)醫(yī)療事故的民事賠償訴訟中,重新鑒定的次數(shù)得不到控制,醫(yī)學(xué)鑒定實(shí)際上被規(guī)避,訴訟效率降低,當(dāng)事人的訴訟負(fù)擔(dān)在一定程度上也有所加重。本文擬通過(guò)對(duì)醫(yī)患糾紛法醫(yī)學(xué)鑒定和醫(yī)學(xué)鑒定程序的比較,從鑒定人的選擇、鑒定的標(biāo)準(zhǔn)和依據(jù)、鑒定的具體程序、鑒定結(jié)論的形式等方面出發(fā),尋求兩種鑒定程序的異同,并進(jìn)一步提出司法鑒定機(jī)構(gòu)介入訴訟中醫(yī)療事故鑒定的設(shè)想,將司法鑒定作為與醫(yī)學(xué)鑒定并行的程序,由當(dāng)事人自由選擇,從而賦予當(dāng)事人對(duì)程序的選擇權(quán),改變目前訴訟中醫(yī)學(xué)會(huì)專屬鑒定的現(xiàn)狀,從程序正義滿足當(dāng)事人對(duì)實(shí)體公正的要求。同時(shí),通過(guò)兩種程序的比較,對(duì)司法鑒定機(jī)構(gòu)開(kāi)展醫(yī)學(xué)鑒定的不足和缺陷作一探討,并完善司法鑒定機(jī)構(gòu)開(kāi)展醫(yī)療事故鑒定的程序,為通過(guò)訴訟程序及時(shí)解決醫(yī)患糾紛提出新的設(shè)想,以解決目前醫(yī)療糾紛民事賠償訴訟中的一些矛盾。
[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.
【學(xué)位授予單位】：華東政法大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2008
【分類號(hào)】：D919.4

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