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医疗侵权责任研究
【作者】 赵阳；
【导师】 杨丽珍；
【作者基本信息】 西北大学 ， 民商法学， 2009， 硕士
【摘要】 近年来,医疗侵权责任作为一种特殊的侵权责任备受学界关注,又因它与老百姓的生活息息相关,因此,它已经从一个单纯的学术问题上升为一个社会问题。如果这一问题得不到很好的解决,和谐医患关系的构建就会因这关键环节的缺失而成为一纸空谈。在这一背景下,医疗侵权责任问题的研究,就被赋予了更为重大的现实意义,所以笔者就以此为切入点,进行了探讨和研究。本文除引言外分为五个部分:第一部分笔者对医疗侵权责任的概念予以阐述,认为医疗侵权责任是指,医方对基于医疗活动侵犯患者人身权和财产权的行为引起的不利民事法律后果的承担。通过医疗侵权责任与一般侵权责任及医疗违约责任的比较,来突出医疗侵权责任的特殊性。在此基础上阐明笔者的观点,认为应该从侵权责任角度来规制医疗责任。第二部分为文章的重点。笔者从过错、加害行为、因果关系、损害结果四个侵权责任的要件来论述医疗侵权责任的构成,其中过错的认定标准应该变通、细化、地方化;防御性医疗行为和侵犯患者隐私权作为两种特殊的加害行为表现方式,在其含义、构成及控制上均与一般的加害行为都有一定的区别;因果关系的认定标准应该采取“全面综合说”,笔者结合实践对其进行了论述;损害结果具体应该包括对患者身体权、生命健康权、财产权、隐私权和精神的损害。第三部分从合理风险和患者知情同意两个方面,论述了医疗侵权责任的免责事由,以此作为医方违法性阻却的救济途径。本文认为合理风险得以成为免责事由的条件是医方所为的医疗行为必须具有合理性、可行性、可用性和具备实施此行为的主客观条件。对于患者知情同意,笔者从其主体、对象、范围几方面问题给予了明确界定,并认为其成为免责事由的条件是主体必须是具有完全民事能力的患者本人,患者做出同意必须以医方做出详尽说明为前提,必须出于自愿且应该在侵权损害发生之前做出。第四部分论述了医疗侵权举证责任。法律明确规定医疗侵权举证责任采取的是举证责任倒置的分配方式。笔者认为立法者选择这种分配方式的深层原因是医患双方信息不对等。在实践中,举证责任倒置对医疗侵权诉讼带来了正面和负面的影响,针对其负面影响,笔者进一步阐明了对举证责任倒置适用时需注意的问题。第五部分是针对医疗侵权损害赔偿问题的探讨。在这部分中,笔者将全面赔偿原则作为医疗侵权损害赔偿的一般原则,并认为其在适用上应予以变通。并在此基础上将惩罚性原则作为例外,对其含义、必要性和具体适用进行了论述。
【Abstract】 As a special kind of tort liability, the medical tort liability has driven a great deal of academic attention recently. And because of its close relationship to people’s daily life, it has moved from a purely academic issue into a social problem. If this problem can not be well resolved, the construction of our harmonious society will be obstructed. Therefore, the study on the liability of medical tort is of greater realistic significance against the special social background. The dissertation is divided into five parts except the introduction:The concept of the medical tort liability is clarified to highlight the particularity and advantages of the medical tort liability in part one. The medical tort liability is assume of the disadvantaged consequences in legal by the medical service provider because of his infringement the property rights and personal responsibility. And then the author states her views on the coincidence of the liability for breaking the contract and the liability for torting to ensure that the infringee should claim her leagal right against the infringer’s liability for torting. All these discussions ground for and direct the following writings.Part two is the main part of the dissertation. The liability of medical tort is recognized by the five essences of tort liability which are the fault, the act of tort, the causation, the damage and the infringer. In discussing this issue, the author omitted the enumeration of the fundamental issues as most textbooks do, but came to see the issue in a new light by the typical problems in practice.The immunity of medical tort liability are discussed from the aspects of reasonable risks and the patient’s agreement in part three. It is argued that there four necessary points for reasonable risks to become the reason of immunity of medical tort liability. They are reasonability, feasibility, usability and subjective and objective conditions. Patients scienter is also deeply discussed in terms of its subject, object, confine and condition to be the reason for immunity of medical tort liability.The realization of medical tort liability is discussed in part 4. It is clarified by law that burden of proof of medical tort liability is inversion. It is argued that the disequilibrium of information between two subjects is the reason for this. Inversion of burden of proof brings positive and negative affection to relevant lawsuit in operation. Problems in operation are discussed based on negative affection.Part five focuses on compensation for medical tort liability. Complete compensation principal is taken as an fundamental principal of compensation for medical tort liability in this part and flexibility is also advised in operation. The punishing principal is taken as an exception whose concept, necessary and operation are also discussed.