我国医疗损害鉴定的实践问题与对策

发布时间：2018-03-25 00:06

本文选题：医疗事故　切入点：医疗过错　出处：《广东财经大学》2017年硕士论文

【摘要】：现阶段,医疗损害纠纷日益增多,医疗损害鉴定意见成为了法院认定医疗损害案件事实的重要依据,医疗损害鉴定意见的科学性和公正性直接影响着纠纷的解决。目前,我国医疗损害鉴定在司法实践中仍存在着诸多问题。因此,本文通过分析我国当前医疗损害鉴定制度的相关法律法规,结合司法实践典型案例,引出医疗损害鉴定的司法实践问题,从立法和实践的角度分别探讨医疗损害鉴定实践障碍的成因,并针对实践障碍提出相关对策,试图构建一个统一、规范的医疗损害鉴定制度。本文除了前言和结语外,共分为三部分展开论述:第一部分主要是对医疗损害鉴定的实践检视。该部分从实践演变的角度展示各时期不同的医疗损害鉴定体制,分析各时期鉴定体制中存在的弊端及其发展。同时,以实践中三个司法典型案例为研究对象,引出医疗损害鉴定实践中所存在的问题,主要包括鉴定体制“双轨制”、异地鉴定难以推开、鉴定意见的采信混乱等问题。第二部分主要是对产生医疗损害鉴定实践问题的原因进行剖析。该部分主要从四个方面展开讨论,第一方面从“双轨制”鉴定制度、鉴定主体、听证制度、重复鉴定和错误鉴定追责制度五个方面去分析医疗损害鉴定的立法缺陷。第二方面从医疗过错的复杂性、鉴定的专业性、鉴定检材的有限性和相关管理机制的问题四个方面去剖析鉴定意见的生成障碍。第三方面对实践中阻碍异地鉴定实施的原因进行说明。第四方面,通过医疗损害赔偿诉讼中法官对“无过失医疗过程”的追求以及对鉴定意见的依赖等相关审理行为,对实践状态进行反思。第三部分主要是提出解决医疗损害鉴定实践问题的对策。该部分主要针对前述医疗损害鉴定的实践问题,从相关法律法规、鉴定主体、鉴定程序等方面提出解决的对策,主要包括三方面的内容,在立法的角度上,从鉴定范围、鉴定程序、鉴定意见采信规则去完善医疗损害鉴定制度。在构建统一的医疗损害鉴定体系的角度上,从统一的鉴定机构、规范的专家鉴定人资格标准和统一的鉴定机制运行模式去解决医疗损害“双轨制”问题。在规范异地鉴定的角度上,从异地鉴定的适用范围及启动、鉴定机构的选取等相关规定去推动异地鉴定的发展。力图构建更加公正合理的医疗损害鉴定体系。
[Abstract]:At present, the medical injury dispute is increasing day by day, the medical injury appraisal opinion has become the important basis for the court to determine the fact of the medical injury case, the scientific and impartial opinion of the medical injury appraisal opinion directly affects the settlement of the dispute. There are still many problems in the judicial practice of medical injury appraisal in our country. Therefore, by analyzing the relevant laws and regulations of the current medical injury appraisal system in our country, combined with the typical cases of judicial practice, This paper introduces the judicial practice of medical injury appraisal, probes into the causes of the practical obstacle of medical injury appraisal from the angle of legislation and practice, and puts forward some relevant countermeasures in view of the practical obstacle, and tries to build a unified system. In addition to the preface and conclusion, It is divided into three parts: the first part is mainly to examine the practice of medical injury identification. At the same time, taking three typical judicial cases in practice as the research object, the problems existing in the practice of medical injury appraisal are introduced. Mainly including the appraisal system "two-track system", it is difficult to push the appraisal in different places. The second part is mainly to analyze the causes of the practical problems of medical injury identification. This part mainly discusses from four aspects. First, from the "two-track system" appraisal system, the main body of appraisal, The system of hearing, the system of repeated identification and the system of liability for false identification are five aspects to analyze the legislative defects of medical injury appraisal. Second, from the complexity of medical fault and the professional nature of identification, The limitation of appraisal materials and the problems of relevant management mechanism are analyzed in four aspects to analyze the obstacles to the formation of appraisal opinions. The third aspect explains the reasons that hinder the implementation of the appraisal in different places in practice. The fourth aspect, Through the pursuit of "no-fault medical process" by the judge in the lawsuit for medical damages, and the reliance on the appraisal opinion, The third part is to put forward the countermeasures to solve the practical problem of medical injury appraisal. This part mainly aims at the practice problem of medical injury appraisal, from the relevant laws and regulations, the appraisal subject, Measures to solve the problem are put forward in the aspects of appraisal procedure and so on, which mainly include three aspects. From the angle of legislation, from the scope of appraisal, the appraisal procedure, In the view of constructing a unified medical damage appraisal system, from the point of view of establishing a unified medical damage appraisal system, from the point of view of a unified appraisal institution, The standard standard of expert appraiser qualification and the unified appraisal mechanism operating mode are used to solve the problem of "double track system" of medical damage. From the point of view of standardizing the appraisal of different places, the scope of application and the starting of the appraisal of different places are discussed. The selection of identification institutions and other relevant provisions to promote the development of remote identification and try to build a more fair and reasonable medical damage identification system.
【学位授予单位】：广东财经大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：D922.16

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