摘要
随着社会主义人权的发展及公民维权意识的增强,伴随而来的医疗损害赔偿案件也呈逐年上升的趋势,因医疗行为的专业性、医疗水平的时限性及发展性、医疗结果的不确定性,医疗侵权行为的认定也具有其特殊性。尽管2002年4月国务院颁布了《医疗事故处理条例》,对于人民法院审理医疗损害赔偿案件有一定的指导作用,但这毕竟是一部行政法规,在许多方面还存在不完善之处。
为了使人们对医疗损害赔偿有更清晰的理解,也为了使对医疗损害赔偿的实现更加公正,本文从医疗损害赔偿的基本理论、医疗损害赔偿的构成要件、医疗损害赔偿案件的审理和法律适用和我国医疗损害赔偿立法设计的建议四个方面对医疗损害赔偿问题进行分析和探讨。希望能对我国医疗损害赔偿的法律理论研究和实践做出一些贡献。
The law cases of medical accident indemnity have been increased gradually, with the development of human rights in socialistic society and the strengthening of the consciousness of preserving rights among citizens. Due to the specialty of medical treatment and the limitation and development of the medical technique as well as the uncertainty of its results, the judgment for infringement behavior in medical care bears particularity. This thesis analyzes four aspects on medical service damage compensate including the basic theories of medical treatment indemnity, the constituents of compensate, the judgment to these cases and the Legislation design in medical damages, in order to increase people’s understanding towards the compensation and make it fair and square. It hopes that this can be some help to the future study and practice of the law on medical accident compensation.
This thesis can be divided into four parts.
The first part begins with the concept and meaning of medical treatment damage. It suggests that the damage bears both broad sense and narrow sense according to the different legal responsibility and distinctive constituents. Therefore the three situations of licit treatment have been nailed down. Also the seven duties have been put forward with the analysis on main body. This part detailed analyzes the contractual relationship, no-reason managerial relation and compelling diagnosis and treatment relation between bilateral litigants in the medical case. Furthermore the features of the compensation of medical indemnity have been explained here. The complication and difficulty on law adaptation is due to above. Then this part summarizes the developing trend of compensation cases in practice.
The second part discusses the constituents of medical treatment compensation. When there is a contractual relation between the doctor and patient, the compensation will aim at handling contract breach and right infringement; when there is no contract, the indemnity falls in rights infringement. There is some difference between constituents of the two responsibilities: if the doctor breaches the contract to bring the injuries, it should be contractual breach; while if the carelessness doctor bring the injuries, it should be right infringement. Consequently the difference between the two constituents is the contractual breach and right infringement. The contractual breach is more unbearable because it contains not only the medical lapse which means disobey the obligation of the doctor, but also means the treatment effect is far from what has been promised in the advertisement. As a result when the conflict happened, it is suggested to deal in accordance to the major responsibility.
The third part is some discussion about case cognizance and law adaptation on medical damage compensation. In terms of the understanding towards offer as proof the responsibility, it is thought the distribution of offering evidence responsibility is regulated by the civil law. However the judicatory department can endue the judge with the power of free judgment obeying the principles of equity and credit, and distribute freely the responsibility of offering proof according to the need in a concrete case. The parties should be alternate to take the responsibility of offering evidence. This thesis suggests that the medical accident judgment is one of the evidences of civil law. If there is con evidence which has been ratified by the judge, the accident judgment shall not be accepted by the court. If the victim had proved the objectivity of the fact of injury and irregularity of the medical treatment, and if the medical institution can not offer proof to deny the causality and its fault, the court will directly cognizance that the infringement of rights come into existence as long as the illation is obey the objective discipline although there is no appraisal conclusion. As far as the exertion and legal understanding towards compensation criterion, this thesis thinks that when there has already been physical injury, The Regulations for the Dealing with Medical Accidents will be referred to in the present practice. While if not the Judicial Interpretations on Applicative Laws to Cases of the Compensation for Physical Injury by the Supreme People’s Court will be referred to. In terms of the injury compensation rules it is advised to refer to the formula of balancing out the profit and loss and the formula. Based on the The Regulations for the Dealing with Medical Accidents and he Judicial Interpretations on Applicative Laws to Cases of the Compensation for Physical Injury by the Supreme People’s Court mentioned above, this thesis discusses the compensation for mental damage caused by person casualty and analyzes the function, precondition, fundamental principle, rules and amount. Furthermore the thesis also explains the exception of the beneficiary of the compensation and succession for the compensation.
Part four discusses how to improve the concerned laws and regulations on handling medical accidents. It is necessary to legislate on medical treatment dissension or set a particular chapter in the civil law for this. The legislative content should include the right and obligation of the doctor and patient, the medical treatment defect, the causality of the compensation for physical injury, the responsibility baring rules, regulation on offering proof, the criterion on compensation and the valid time for lawsuit. It should also adjust the medical accident and nail down the civil law property. As the increase of compensation amount on medical accident, the occupational risk in medical institutions has been sharpened. Therefore the liability insurance for handling the injury and exempting regulation for medical treatment should be established as soon as possible so that the benefit of both party can be harmonized and the medical industry can make further progress.
引文
[1]李龙畅:《医疗损害赔偿案件审判的有关问题》,“深圳律师法律顾问网”,http://www.szbxls.anyp.com,2007 年 6 月 4 日。
[2]王敬毅:《医疗过失责任研究》,载《民商法论丛》第 9 卷,法律出版社 2001 年版,第 682 页。
[3]龚赛红:《医疗损害赔偿立法研究》,法律出版社 2001 年版,第 35-39 页。
[4]龚赛红:《医疗损害赔偿立法研究》,法律出版社 2001 年版,第 19-21 页。
[5]张敏:《医患纠纷与医疗损害赔偿问题研究》,载《医疗纠纷判例点评》,人民法院出版社 2003 年版,第 280 页。
[6]李龙畅:《医疗损害赔偿案件审判的有关问题》,“深圳律师法律顾问网”,http://www.szbxls.anyp.com,2007 年 6 月 4 日。
[7]张伟:《医疗损害赔偿案件审判问题研究》,“中国法院网”, http://www.chinacourt.org,2007 年 6 月 22 日。
[8]龚赛红:《医疗损害赔偿立法研究》,法律出版社 2001 年版,第 199页。
[9]张新宝:《中国侵权行为法》,中国社会科学出版社 1998 年 8 月版,第 264 页。
[10]梁慧星:《民法》,四川人民出版社 1989 年版,第 353 页。
[11]屈芥民:《专家的民事责任》,湖南人民出版社 1998 年 3 月版,第115 页。
[12]王利明等:《民法新论》(上册),中国政法大学出版社 1987 年版,第 465 页。
[13]郑立、王作堂:《民法学》,北京大学出版社 1994 年版,第 535 页。
[14]梁慧星:《雇主承包厂房拆除工程违章施工致使雇工受伤感染死亡案评析》,《法学研究》1989 年第 4 期,第 47 页。
[15]丁文:《完善我国医疗事故技术鉴定的法律思考》,《山东审判》2006年第 6 期,第 45 页。
[16]杨立新:《论美国医疗损害赔偿制度改革及其借鉴意义》,载张新宝《侵权法评论》(第二辑),人民法院出版社 2003 年版,第 138 页。
[17]王利明:《人格权法新论》,吉林人民出版社 1994 年版,第 664 页。
[18]张新宝:《侵权责任法原理》,中国人民大学出版社 2005 年版,第229 页。
[19]王才亮:《医疗事故与医患纠纷处理实务》,法律出版 2002 年版,第 119 页。
1.杨立新、杨帆:《最高人民法院“关于确定民事侵权精神损害赔偿责任若干问题的解释”释评》,《法学家》2001 年第 5 期。
2.梁慧星:《雇主承包厂房拆除工程违章施工致使雇工受伤感染死亡案评析》,《法学研究》1989 年第 4 期。
3.丁文:《完善我国医疗事故技术鉴定的法律思考》,《山东审判》2006年第 6 期。
4.杨立新:《论美国医疗损害赔偿制度改革及其借鉴意义》,张新宝《侵权法评论》(第二辑),人民法院出版社 2003 年版。
5.林文学:《医疗损害赔偿审判实践中几个法律问题的探讨》,《人民司法》2007 年第 17 期。
1.杨太兰:《医疗纠纷判例点评》,人民出版社 2003 年 7 月版。
2.王敬毅:《医疗过失责任研究》,《民商法论丛》(第 9 卷),法律出版社 2001 年版。
3.龚赛红:《医疗损害赔偿立法研究》,法律出版社 2001 年 9 月版。
4.郑立、王作堂:《民法学》,北京大学出版社 1994 年版。
5.屈芥民:《专家的民事责任》,湖南人民出版社 1998 年 3 月版。
6.杨立新:《侵权法论》,吉林人民出版社 1998 年 9 月版。
7.梁慧星:《民法总论》,法律出版社 1996 年 8 月版。
8.张新宝:《中国侵权行为法》,中国社会科学出版社 1998 年 8 月版。
9.王利明、杨立新:《侵权行为法》,法律出版社 1998 年 1 月版。
10.王利明:《民法新论》上册,中国政法大学出版社 1987 年版。
11.王利明:《人格权法新论》,吉林人民出版社 1994 年版。
12.张新宝:《侵权责任法原理》,中国人民大学出版社 2005 年版。