医疗过错的证明责任分配研究

发布时间：2018-01-15 03:25

本文关键词：医疗过错的证明责任分配研究　出处：《山西大学》2015年硕士论文　论文类型：学位论文

【摘要】：近年来,医疗纠纷案件日渐增多,医患矛盾日益深化,如何公正合理解决医疗纠纷已成为一个不争的社会热点问题。由于医疗活动具有很强的专业性和复杂性,所以医疗过错的认定成为解决医疗纠纷的重点,也决定着患者是否可以得到法律的有效救济,与之相对应的医疗过错的证明责任分配更是重中之重,决定着当事人诉讼的成败。我国《侵权责任法》对医疗诉讼中医疗过错的认定及其证明责任的分配作了详尽的规定,但依旧存在一些弊端,无法适应诉讼的需求。本文从医疗过错的界定入手,探求正确认定医疗过错的方法；并从影响医疗过错证明责任分配的因素入手,分析医疗过错证明责任分配的特殊性；借鉴域外的先进经验,通过建立证明责任缓和规则,以减轻患方的证明负担；以请求权为基础明确规定了医患双方各自的证明责任；并提出完善配套制度的建议,以期对我国合理分配医患双方的证明责任有所裨益。本文除引言和结语外,共包含四大部分内容：第一部分是医疗过错的认定。本部分从对医疗诉讼中医疗过错的界定入手,介绍了医疗过错的综合认定标准,并强调了医疗过错的正确认定对于医疗违约之诉以及医疗侵权之诉都具有显著的意义。第二部分是医疗过错证明责任分配的考量因素。本部分着重介绍了证明责任分配的一般属性,并在此基础上分析了实体法宗旨的实现、医疗行业的特殊性、当事人的举证能力、证明妨碍因素的影响以及医学的发展与成本等五大因素对医疗过错证明责任分配的影响,从而得出医疗过错证明责任的分配具有一定的特殊性。第三部分是国外医疗过错证明责任分配的实践与借鉴。本部分对美国“事实说明自己”法则、德国表见证明原则、重大医疗瑕疵原则以及日本“过失之大致推定”规则进行了介绍,并对以上各国关于医疗过错证明责任分配的实践经验进行了总结,对我国医疗过错证明责任的分配具有重要的启示作用。同时,还指出各国在坚持证明责任分配原则的基础上,都采取了不同的证明责任缓和规则,为我国科学合理分配医忠双方的证明责任提供了域外经验。第四部分是我国医疗过错证明责任分配的完善。本部分针对我国医疗过错证明责任分配存在的问题,提出健全证明责任缓和规则,减轻患方举证负担的建议；并以请求权为基础明确规定了医患双方各自的证明责任；最后通过完善医疗诉讼证明妨碍制度、医疗过错鉴定制度以及病历资料的生成和保管制度等配套制度,以平衡医患双方的举证能力,合理分配医疗过错的证明责任,从而构建和谐的医患关系。
[Abstract]:In recent years, the medical dispute cases are increasing day by day, the contradiction between doctors and patients is deepening day by day. How to solve the medical disputes fairly and reasonably has become an indisputable social hot issue. Because of the strong professional and complexity of medical activities. Therefore, the identification of medical fault has become the focus of resolving medical disputes, but also determines whether patients can get effective relief from the law, and the corresponding distribution of burden of proof of medical fault is the most important. It determines the success or failure of the litigant. The tort liability law of our country has made the detailed stipulation to the medical treatment fault in the medical lawsuit and the distribution of the burden of proof, but there are still some disadvantages. This article starts with the definition of medical fault, and explores the method of correctly identifying medical fault; From the factors that affect the distribution of the burden of proof of medical fault, the particularity of the allocation of burden of proof of medical fault is analyzed. Learn from the advanced experience of foreign countries, through the establishment of the burden of proof mitigation rules, in order to reduce the burden of proof; On the basis of the right of claim, it clearly stipulates the burden of proof of both doctors and patients. And put forward some suggestions to improve the supporting system, in order to reasonably distribute the burden of proof between doctors and patients in China. In addition to the introduction and conclusion of this article. It includes four parts: the first part is the identification of medical fault. This part starts with the definition of medical fault in medical litigation and introduces the comprehensive identification standard of medical fault. It also emphasizes that the correct identification of medical fault is of great significance for both medical breach of contract and medical tort. The second part is the consideration of the allocation of burden of proof of medical fault. This part focuses on the burden of proof. General attributes of any assignment. And on the basis of the analysis of the realization of the purpose of substantive law, the particularity of the medical industry, the party's ability to prove. The influence of proof hindrance factors and medical development and cost on the distribution of burden of proof of medical fault. The third part is the practice and reference of the distribution of the burden of proof of medical fault abroad. In Germany, the principle of proof, the principle of major medical defects and the rule of "presumption of negligence" in Japan are introduced, and the practical experience of the above countries on the distribution of burden of proof of medical fault is summarized. At the same time, it is pointed out that countries have adopted different rules of mitigation of burden of proof on the basis of adhering to the principle of distribution of burden of proof. It provides the extraterritorial experience for the scientific and reasonable distribution of the burden of proof between the medical and loyal parties in China. Part 4th is the perfection of the allocation of the burden of proof of medical fault in China. This part aims at the problems existing in the allocation of the burden of proof of medical fault in our country. To improve the burden of proof mitigation rules to reduce the burden of proof for the affected party; On the basis of the right of claim, the author clearly defines the burden of proof of both doctors and patients. Finally, through the improvement of medical litigation proof obstruction system, medical fault identification system and medical record data generation and custody system and other supporting systems, in order to balance the burden of proof between doctors and patients. Reasonable distribution of the burden of proof of medical fault, so as to build a harmonious relationship between doctors and patients.
【学位授予单位】：山西大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：D923

【共引文献】