论患者隐私权的保护

【作者】 董静；

【导师】 刘士国；

【作者基本信息】 复旦大学 ， 法律， 2011， 硕士

【摘要】 医疗机构因诊疗活动的需要而成为“隐私爆炸”的场所,与隐私侵权相关的纠纷在纷杂的医患纠纷中占据了很大比重。《侵权责任法》对医疗损害责任专辟一章,这既反映了医疗损害责任在侵权责任中的重要地位,也是对现代社会极端紧张的医患关系的无奈反映。患者的隐私权是一种普遍而又独特的隐私权利：普遍之处在于作为其主体的患者可以是任何(与医疗机构建立了医疗关系的)不特定的社会个体；独特之处在于它有很多异于一般隐私权的特征,如权利主体和义务主体的相对特定化、内容的相对集中性、限定性、权利人主观方面的自愿放弃性等。任何权利都有其边界,患者隐私权也是如此。出于公益、防范犯罪等目的,可以对患者隐私权有所限制。与患者隐私权相关的侵权行为构成要件有：1.违法行为,包括：作为方式,如：医方未经患者同意披露、公开甚至利用患者隐私；不作为方式,如指对患者隐私信息资料管理不当,导致患者的隐私信息泄露。2.损害事实,包括隐私信息被披露而引起的精神利益损害、身份利益的实际损害。3.因果关系。4.医疗过失。医疗责任仅仅涉及过失责任,不包括故意,如果医护人员故意损害患者,其行为就已经不是医疗。关于患者隐私权的救济,既可以适用违约责任,也可以适用侵权责任,择一适用。在后一种情况下,《侵权责任法》相对之前的规定作出了修改,区分具体的侵权行为,在医疗机构未经患者同意公开其病历资料的情况下适用过错推定责任原则；而在医疗机构泄露患者隐私的情况下则适用过错责任原则。承担侵权责任的方式为单独或者合并适用停止侵害、赔偿(精神)损失、赔礼道歉、消除影响、恢复名誉等。结合相关案例可以看到,我国的患者隐私权保护还存在一些问题：一是医方需要提高相关意识,一些侵犯患者隐私权的案例反映医方缺乏尊重患者隐私权的意识,其行为简单粗暴。而保护患者隐私权不仅是其法定义务,也是《里斯本宣言》所规定的职业道德义务。二是医疗机构需要健全保护患者隐私权的机制,如患者隐私资料的保管、披露制度。三是需要健全相关法制。虽然目前以《侵权责任法》为纲,我国的相关立法已经比较完善,但其细节多散见于《执业医师法》、《传染病防治条例》、《电子病历基本规范》等,尚不系统,或有缺漏,考虑到医患关系现在是并将长期作为关系社会和谐稳定的重要因素之一,有必要出台一部系统的专门法律。更多还原

【Abstract】 Health care institutions are where privacies "explode" due to the attributes of their engagements. As a result, disputes related to the infringements of privacies have accounted for considerable share comparing with their counterparts. Hence, the newly released Tort Liability Law provides separate provisions on Liability for Medical Malpractice, where tort liability for the tort of a Patient’s Privacy is manifested.The Patient’s Privacy (Right) is a legal terminology of both universality and uniqueness. It’s universal in terms of its principal, who shall be any randomly designated individual (who has established medical relationship with the health care institution); it’s unique in terms of the subjects of the duty, who are specified health care institutions, and of the content of the right, which are exposed only in medical related activities, and of the subjective psychology of the principal, who volunteers to renounce some of his/her privacies for the sake of coordinating with the medical engagement. Like all other legal Rights, it is subject to some limitation, i. e. for the public interest, for the prevention of a crime, etc. in its case.The constructive elements of an infringement of the Patient’s Privacy are:1. malpractice, including activities such as the disclosure or use of the Patient’s privacy without authorization, and nonfeasance, which refers to the leakage of the Privacy due to inappropriate storage of the Patient’s medical documents; 2. the damage fact, exemplified by the spiritual agony caused hereto; 3. the causality between the malpractice and the damage fact; and 4. the negligence from the heal care institution part.The plaintiff shall cite either the breach of contract or tort liability to seek remedy for his damage. Where it is tort liability, the newly issued Tort Liability Law has made slight modifications, distinguished the acts of tort - where the medical institutions disclose the privacy information without permission for the patient, the doctrine of presumption shall be used to identify the liability; where the privacy information is revealed from the medical situation, the doctrine of fault shall be used.The cases reveal some problems in the protection of the Patient’s Privacy. One is that the medical institution party shall elevate its awareness of protection, which is not only an obligation of legality, but also of morality as is stipulated in the WMA Declaration of Lisbon on the Rights of the Patient. Two is that appropriate institutions, such as that to manage the medical document, shall be introduced. Three is that further legislation is needed. Thanks to the enforcement of the Tort Liability Law, the law protecting Patient’s Privacy is outlined. However, details hereto are dispersed in various laws and regulations, such as the Law on Medical Practitioners, Law on the Prevention and Treatment of Infectious Diseases, etc., whose content are far from being sufficient. Hence, a congregated law like the Health Insurance Portability and Accountability Act in the US is welcomed.更多还原