准确分析伤病关系是人体损伤程度鉴定的关键

Analyze the Causation between Injury and Disease,and Assess the Degree of Injury Correctly

损伤与疾病的关系是法医临床鉴定实践中经常遇到的问题,在人体损伤程度的鉴定中往往直接关乎鉴定意见,值得高度重视。最新发布的《人体损伤程度鉴定标准》对伤病关系处理原则做出了规定,是法医学的一大进步。准确分析伤病关系,要掌握损伤、疾病、损伤性疾病及损伤后疾病、病理基础、潜在性疾病及既往伤病等概念,对损伤与疾病的因果关系进行恰当的分析,并将分析结果运用到损伤程度的鉴定中。在伤病关系分析时,应当遵循事实因果关系的认定原则,从时间上的先后关系、解剖部位上的吻合性以及逻辑上的关联等角度加以论证。损伤程度的鉴定须遵循刑事证据的证明原则,排除合理怀疑,故鉴定人应注意采用恰当的分析方法,尽可能从更高的标准证明伤病关系是否存在。病理学、病因学、临床学上的因果关系,其证明价值要显著高于流行病学、案例报道及实验医学上的因果关系,在实际应用中应高度关注。

The causation between injury and disease is a common problem in clinical forensic medicine. It is closely related to the assessment of injury degrees, therefore deserves great attention. The latest standard of human body injury assessment makes a great progress in regulating the assessment principles on this problem. It is necessary to understand many concepts, such as injury, disease, injury disease, postinjury disease, pathological foundation, underlying disease, anteinjury disease and so on. An accurate analysis of the causation between injury and disease is necessary in the assessment of injury levels. Thee analysis ought to be based on the principles of factual causation, with concerns about the time sequence, the consistency of anatomic site, the logical relationship, etc. In the assessment of injury levels, the principles in proofing criminal evidence should be followed. Hence, proper methods and more critical standards should be adopted to exclude reasonable doubts. It also should be noticed that the causation analysis based on pathology, etiology and clinic, is of higher value than that based on epidemiology, case report, and experimental medicine.