【作者】 李云霞；

【导师】 许庆坤；

【作者基本信息】 山东大学 ， 在职法律， 2011， 硕士

【摘要】 本文以医疗行为及医疗损害责任为题,兼论《侵权责任法》的立法不足。正文由四章构成。前三章全面分析了医疗行为、医疗损害责任、医疗损害赔偿责任的构成要件、举证责任及举证责任分配等相关理论内容并对医疗技术损害责任的归责原则及举证责任分配提出了立法建议。第四章结合立法精神和相关理论,主要针对我国目前新施行的《侵权责任法》,分析了现实立法不足,阐明了自己的观点和立法建议,以切实保障医患双方合法权益,促进法律制度不断完善和医疗卫生事业的健康发展。第一章剖析了医疗行为的概念,概括总结了医疗行为具有主体适格性,医疗行为的慎独性、风险性,技术标准评价的相对性、侵害性、自主性、协同性和系统性等外在特征,并从不同角度对医疗行为进行了分类。文章同时指出医疗损害责任的概念,阐明了医疗损害责任的基本特征和基本类型,并对医疗行为及医疗损害责任的关系予以辨析。第二章结合《侵权责任法》的规定分析研究了医疗行为损害赔偿的构成要件,即由医疗损害事实、医疗行为违法、医疗行为过失、医疗行为与损害结果之间的因果关系等要件构成。文章分别对指出医疗损害含义及分类。分析了医疗损害行为违法及处置,对医疗过失进行了分析,并分析了权衡医疗过失时应参考的因素。《侵权责任法》第54条规定了患者损害如发生在诊疗活动中并且医疗机构及其医务人员有过错的,赔偿责任由医疗机构承担。该条规定把“医疗行为与损害结果之间的因果关系”要件排除在法律考量的范围之外。第三章对举证责任及举证责任分配进行了分析,阐明举证责任的概念及法律特征,指出了举证责任分配原则的含义及应遵循的原则。本文还归纳了我国举证责任分配的“谁主张谁举证”原则、举证责任倒置原则、法院分担当事人的举证责任原则、法官自由裁量分配举证责任原则。文章分析总结了医疗损害责任的归责原则概念和分类后,根据侵权责任法中医疗损害责任的不同类型指出了应适用的相应的归责原则。本文最后对医疗技术损害责任的举证责任分配提出了立法建议。第四章提出了关于侵权责任法的其它立法建议,如分别提出了对《侵权责任法》结构适当调整优化的建议、补充“过度治疗责任”的规定及司法解释的建议、补充“医疗机构法定免责事由”的司法解释建议、改善医疗损害责任鉴定双轨制不科学的现状的建议。更多还原

【Abstract】 This paper focuses on medical acts and liability for medical damages, and also discusses the deficiencies of Tort Law. It consists of four parts. The former three chapters analyze the related theories like constitutive requirements of medical acts, liability and compensation liability for medical damages, burden of proof and the distribution of burden of proof, and also make legislative proposals for the imputation principles and distribution of burden of proof. Considering the spirit of the legislation and related theories on the basis of the current Tort Law, Chapter Four analyzes the shortages of the current law and brings forward individual opinions and legislative proposals, for the purpose of protecting the legitimate rights and interests of both doctors and patients, and contributing to the improvement of our legal system and the development of our country’s medical and health undertakings.Chapter One studies the concept of medical acts and sums up the external characteristics of subject compatibility, the caution and risk of behavior, the relativity, harm, self-independence,cooperatives, systematicness of the technical standard, and classifies medical acts from different angles. The paper also gives the concept of medical damages, illustrates the basic features and types of liability for medical damages, and analyzes the relationship between medical acts and liability for medical damages.Chapter Two analyzes the constitutive requirements of compensation liability for medical damages, that is, the fact of medical damages, illegal medical acts, and medical malpractice. The paper brings forward the concept of medical damages and its classification, analyzes illegal medical acts and corresponding punishments, and medical malpractice (mainly are caused by medical faults) and factors that should be considered in measuring. According to Section 54 of Tort Law, if injuries occur during medical diagnosis or treatment and the medical institution and its medical workers proved to be wrong, the responsibilities lies on the medical institution. This eliminates the causal connections between medical acts and damages. Chapter Three analyzes burden of proof and its distribution, illustrates the concept and its features of burden of proof, and also points out the meanings and principles of it. The paper summarizes the principle that "the proof lies upon him who affirms", onus proof of conversion, the allocation of burden of proof by judges, judges’right of discretion to onus proof. After analyzing the concept and different types of imputation principles, the thesis points out the corresponding principles of different medical damages according to Tort Law. The last part of the thesis gives some legislative suggestions on the imputation principles and distribution of burden of proof.Chapter Four proposes some other pieces of legislation suggestions for Tort Law, including optimizing and adjusting the structure, supplementing "the liability for overtreatment" and its judicial interpretations, supplementing judicial interpretations of "excuse for non-responsibility", improving the double-track system in medical appraisal and building medical responsibility insurance system as soon as possible.更多还原