【作者】 盛皓；

【导师】 张利民；

【作者基本信息】 苏州大学 ， 法律， 2003， 硕士

【摘要】 随着社会的进步，医疗技术的提高，人权意识的高涨，医疗纠纷逐渐成为社会热点问题，也是引起争议最多的领域之一。目前，我国法律关于医疗损害赔偿的有关规定尚有许多不完善的地方，这些问题都给医疗损害赔偿案件的正确处理带来了一定的影响，不符合现代社会中法律加强对弱者保护的趋势，也不利于健康医患关系的建立。 本文从分析医患关系的特点入手，阐述了医患关系是一种合同关系，这种合同有着与一般合同所不同的特点，其性质类似于委托合同。 文章的大部分篇幅讨论了医疗损害的构成要件及举证责任分配、赔偿范围问题。作者的主要观点有：1、过失是构成医疗损害的基本要件，医生的过失就是对医生注意义务的违反，这种注意义务范围广泛，文中对说明义务和转医义务进行了讨论；另外关于确立医生注意义务的抽象判断标准，文章提出了以医疗水准为基准结合医疗专门性、地域性、紧急性因素来进行综合判断的观点。2、因果关系是构成医疗损害的另一个要件。医疗损害因果关系是民法因果关系中的一种特殊类型，具有特殊性。应考虑到医学的特点及患者本身的体质情况，对损害责任及赔偿责任范围与过失之间的因果关系进行具体分析。3、举证责任的正确分担是公平合理处理医疗损害赔偿案件的关键，对于最高法院关于举证责任倒置的规定应正确理解和适用。医疗机构的举证责任并非无休止和绝对的，在一定的时机存在举证责任转化的情况。医疗损害赔偿法律问题初探中文提要并且患者对所受损害也存在相应举证责任。么要正确适用法律，对《医疗事故处理条例》四十九条第二款“不属于医疗事故的，医疗机构不承担赔偿责任”要正确理解，医疗机构对医疗事故所引起的损害应适用《医疗事故处理条例》，对于虽不构成医疗事故，但医疗机构有过错，且过错与患者所受损害有因果关系的，应适用《民法通则》的规定，给受害人相应救济。 文章的最后，作者对于我国现在的派疗立法的指导思想和具体规定提出了自己的观点，认为虽然医疗立法取得了成绩，但尚存在许多不足，在指导思想上过多地考虑了医疗机构的福利性，从而导致对患者利益的保护上力度不够，有些规定不符合现代民法的基本原则。列举了《医疗事故处理条例》不够合理的规定并作了相应分析。最后作者据此提出了对于医疗损害赔偿立法的一些建议，认为应制定专门的医疗损害赔偿法，在内容上应修正现行法律有待完善的地方，借鉴其他国家己经成熟的傲法，改革医疗揖害籍偿韵鉴定制度，建立医疗保险制度，以适应社会地发展，更好地保护人们的基本权利。更多还原

【Abstract】 With the development of the society, advance of medical technology and people’s awareness of human rights, the medical disputes have increasingly become one of the hot topics. However, there are a lot of defects in our medical damage and compensation regulations. These defects hinder the medical disputes from being settled fairly. It seems obvious that some articles in our laws are not compatible with the modern trend of protecting the weak. They have become obstacles to the establishment of healthy relationship between doctors and patients.This article discusses the characteristics of the relationship between doctors and patients. It defines the relationship as a contract one, the nature of which is similar to that of entrustment contract.Author tries to analyze the substantial forming elements of the medical damage, the allocation of proof duty and the extent of compensation. Main points of the article are as follows:i) Negligence, in other words, the doctors’ breach of the care duty, is the basic element to constitute medical damage compensation. This care duty is very comprehensive. The article illustrates the duties of instruction and transfer of hospital in case of incompetence. It also discusses the criteria about the judgment of the breach of care duty. Writer suggests the medical technology situation should be a basic consideration, while medical properties, location, emergency and other details should all be taken into account.ii) The causality between the medical service and the damage is another substantial element. In medical area, the causality has its own characteristics.Patients’ special physique and medical service properties are important in deciding if there exists causality.iii) Allocation of the burden of proof is very essential to the settlement of medical damage complaints. There is a relatively strict rule by the Supreme Court of China, which requires the medical service suppliers to take the duty of proof in medical disputes settlement. Sometimes, this rule is misunderstood and incorrectly applied. In some circumstances, the patients shall be asked to take part of the proof duty.iv) Damage claims arising from unskillful and fealty medical treatment shall be settled according to The Regulation on Malpractice, other complaints arising from medical neglect, which are not so severe to form the malpractice in The Regulation on Malpractice, shall be settled according to General Principles of Civil Law.Finally, the author presents proposals on the amendment of the existing legal system about medical damage. Although the regulations have contributed a lot to the settlement of medical disputes, it pays too much attention to the public welfare property of hospital; consequently it does not afford sufficient protection for the patients. Some articles are even in conflict with general principles of modern laws. So, it is feasible to enact a new special medical law or a uniform medical law. New law will take the responsibility of establishing new system. It should adopt the sophistic practices of China and abroad. New law is expected to meet with the need of society development, and to protect human rights in a more effective way.更多还原