论医疗行为及其损害的民事责任
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摘要
本文以医疗行为及其损害的民事责任为题,兼论《医疗事故处理条例》的立法不足。全文由引言,正文四章及结束语三部分构成。
    引言揭示了医疗纠纷严重程度及解决它的紧迫性意义。提出了“举证责任倒置”规则适用于医疗纠纷诉讼和《医疗事故处理条例》不能担当特别法的观点。
As the title shows, the thesis discusses medical conduct and the liability of its malpractice, with a referential touch on the legislation inadequate of The Medical Accident Treat rules. It can be divided into three major parts, introduction, main body, including four chapters, and postscript.
     In the introduction, I point out the urgency for the proper resolution of the medical disputes based on the statistics, which shows that such disputes have caused severe social problems. Meanwhile, I think that the related measures stipulated by Regulations on Evidence in Civil Lawsuits by Supreme People's Court is suitable. It orders: "The Medical organization should be responsible for offer evidences to prove its innocence in civil lawsuits on medical disputes ". But the Medical Accident Treating Rules issued by State Council has some deficiency and does not play the role of the special law.
     In chapter one, a definition of medical conduct is put out based on an overall analysis on different medical conducts. In the same time, I point out the deficiency of specific definitions about medical conduct. I prefer "medical conduct" to "medical activity" as a legal term used in medical law. A new definition is put out with reference to that which prevalent in China and that which prevalent in Japan. According to the new one, medical conduct can be defined as labor both physical and mental of people who are permitted by law. They apply general medical knowledge and techniques including those of physics, chemicals, biology, psychology and sociology to intervene in health of single person and group. Medical conduct is a kind of
    
    social behavior characterized with antagonism and unity between sociality and physicality, interest and justice, and subjective will and objective law. It appears as follows: at first, the qualification of it is strictly regulated by the law and all the society pay much attention to it. Secondly, it needs the operator having conscious responsibility in the conduct, taking care of patients and keeping secrets. Thirdly, medical conduct is a special conduct which causes unexpected effect or may be of risks. And the standard of estimation to it is of uncertainty. So that medical conduct should be regulated with special law. In medical lawsuits it is the medical organization, not the patients that should offer evidence, i.e. the so-called "the inversion principle of evidential responsibility ". And medical conduct can be exempt from liability in certain circumstances. Medical conduct can also be divided into many kinds according to different needs. It can be divided into legitimate and illegitimate, dominant and auxiliary, clinical and experimental, curable and incurable, etc. In the last part of this chapter, the writer also points out that the definition about the medical conduct in administration of medical affairs is not specific.
     The compensation caused by the malpractice of medical conduct is deeply investigated. It is based on three elements, medical errors, malpractice of medical conduct and the corollary relationship between the two. The fact of medical errors is the ground of compensation. But there is no notion like medical errors in the Rule Dealing with Medical Accidents. According to the rule, only medical accident can be requested compensation, i.e. it is only severe medical errors directly caused physical damage or loss of property to the patient that can be compensated in law. Now a Chinese scholar Gong Sai Hong put a new notion of medical damage, which includes all kinds of damage caused by the malpractice of medical conduct, not only physical damage and loss of property , but also mental pain and loss of reputation to the patient. Gong Sai Hong's view is comprehensive and illuminable to protect the patient's right and interest. But from another point of view, we must define the obligation of the medical organization in law. Only in this way can we confirm whether it is liable to the medical errors. At any rate, the obligation of the medical conductor can be divided in
引文
一、中文参考书目
    1、柳经纬,李茂年,《医患关系法论》,中信出版社,2002年10月版。
    2、龚赛红,《医疗损害赔偿立法研究》,法律出版社,2001年9月第1版。
    3、唐德华主编,《<医疗事故处理条例>的理解与适用》,中国社会科学出版社,2002年5月第1版。
    4、王才亮,《医疗事故与医患纠纷处理与实务》,法律出版社,2002年7月第1版。
    5、何颂跃,《医疗纠纷与损害赔偿新释解》,人民法院出版社,2002年1月第1版。
    6、陈平安,《中国典型医疗纠纷法律分析》,法律出版社,2002年11月第1版。
    7、(台湾)黄丁全,《医事法》,元照出版社,2000年7月,元照初版第1刷。
    8、王利明,《民法典·侵权责任法研究》,人民法院出版社,2003年2月第1版。
    9、(台)王泽鉴,《侵权行为法(第一册)》,中国政法大学出版社,2001年7月第1版。
    10、王卫国,《过错责任原则:第三次勃兴》,中国法制出版社,2000年5月北京第1版。
    11、王利明,《民法·侵权行为法》,中国人民大学出版社,1993年7月第1版。
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    13、屈介民,《专家民事责任论》,湖南人民出版社,1998年3月第1版。
    14、徐爱国,《英美侵权行为法》,法律出版社,1999年10月
    
    第1版。
    15、于敏,《日本侵权行为法》,法律出版社,1998年11月第1版。
    16、罗振华、孙方敏,《医疗纠纷典型案例剖析》,第二军医大学出版社,1999年3月第1版。
    17、李步云,《法理学》,经济科学出版社,2000年12月第1版。
    18、吕学静,《各国社会保障制度》,经济管理出版社,2001年2月第1版。
    19、杜乐勋,郝秀兰,《中国医院产权制度研究》,哈尔滨出版社,2001年3月第1版。
    20、世界卫生长组织宏观经济与卫生委员会报告,《宏观经济与卫生》,人民卫生出版社,2002年9月第1版。
    21、江伟,《民事诉讼法》,中国人民大学出版社,2000年3月第1版。
    22、王利明,《民法》,中国人民大学出版社,2000年6月第1版。
    23、丘祥兴,《医学伦理学》,人民卫生出版社,1999年8月第1版。
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    25、董恒进,《医院管理学》,上海医科大学出版社,2000年8月第1版。
    26、范愉,《非诉讼纠纷解决机制研究》,中国人民大学出版社,2000年6月第1版。
    27、克雷斯蒂安·冯·巴尔,《欧州比较侵权行为法》(上、下卷),张新宝、焦美华译,法律出版社,2001年12月第1版。
    28、林嘉,《社会保障法的理念、实践与创新》,中国人民大学出版社,2002年4月第1版。
    29、汪治平,《人身损害赔偿若干问题研究》,中国法制出版社,
    
    2001年10月第1版。
    30、黄钢、何伦、施卫星、《生物医学伦理学》,浙江教育出版社,2001年8月第2版。
    31、李永军,《合同法原理》,中国人民公安大学出版社,1999年7月第1版。
    二、英文参考书目及文献
    1、EDWARDJ·KJONKA·《Torts》 1992 west group,(英文影印版由法律出版社和west Group合作出版,1999年10月第1版。
    2、ErichE·Brueschke et al 《The world Book Medical Encyclopedia》1995,World Book,Inc,525W·Monroe Chicago,IL60661(世界图书出版西安公司 重印发行,1999年7月第1次印刷)
    3、John·Fraser,Jr,MD,JD, and the Committee on medical Liability,Technical Report:Alternative Dispute Resolution in Medical Malpractice (RE9943),Dediatrics,Volume 107,Number 3 March 2001·pp602-607。
    4、David T, Caldon,Medical Malpractice Disputes in the Age of Managed Care,WWW·mediate.com
    三、重要参考论文
    1、程宗璋,《西方国家血液安全的责任与赔偿》,《临床误诊误治杂志》,2002年2月第5卷第1期。
    2、厦芸,《医师的说明义务评说》,《南京中医药大学学报(社会科学版)》,2001年12月第2卷第4期
    3、武汝廉,《议我国卫生服务市场政府管制》,《中国卫生经济》,2002年8月第8期第21卷,总234期。
    4、William C·Cockerham,《医疗保健是权利还是特权》,《医学与哲学》,2002年11月第23期,总258期。
    5、孙宝良,《现代医学存在自身缺陷的依据、原因、现象及其后果》,《医学与哲学》,2002年1月第23卷,总248期。
    
    
    6、高也陶,《美国民事侵权法的基本概念与中美两国医疗差错处理的比较与思考》,《医学与哲学》,2002年1月第23卷,总248期。
    7、黄军辉,《医患关系的法律规制》,《法律与医学杂志》,2002年第9卷第1期。
    8、李运华,《论医患关系的经济本质与法律本质》,《医学与社会》,2002年8月第15卷第4期。
    9、兰迎春等,《正确认识和对待“举证责任倒置”》,《医学与哲学》,2002年7月第23卷第7期总254期。
    10、刘鑫,《医疗损害限额原则的理论探讨》,《法律与医学杂志》,1999年第6卷第1期。
    11、李小平,《关于设立医疗损害赔付基金的建议和思考》,《临床误诊误治杂志》,2003年1月第16卷第1期。
    12、陈玉玲,《强制责任保险:我国医疗责任保险发展取向》,《上海金融》,2002年第1期。
    13、孙东东、刘瑞爽,《(医疗事故处理条例)辨析》,《法律与医学杂志》,2002年第9卷第3期。
    14、宋咏堂,《媒体报道85例医疗过失精神损害赔偿费分析》,《法律与医学杂志》,2002年第9卷第3期。
    15、张建军,《医疗过错:现实立法与学者意向》,《法律与医学杂志》,2003年第10卷第2期。