美国医师道歉制度及其对证据法的影响

Studies on American physician apology system and its impact on evidence law

在病人安全运动的推动下,从上世纪80年代开始美国各州陆续制定了道歉法案,并逐渐确立了排除医师道歉自认效力的制度。该制度实施以来,理论界一直争议不断。各州的医师道歉制度在内容、形式、时间、对象及是否仅适用于诉讼程序方面不尽相同,也导致实务中医师因担心法律风险而拒绝道歉,以及法院挑选等问题。不过,理论和实证研究数据均表明,该制度的确能够减少医疗诉讼数量、降低医疗损害索赔数额,从而缓和医患关系。为了使其更好的发挥作用,学者们提出了对联邦证据法的修订建议。在构建和谐医患关系的目标下,该制度及其对证据法的影响,值得我国加以学习和借鉴。

Under the impetus of patient safety movement, from the 1980s several states in the United States have enacted Apology Law, and gradually established Physicians Apology System. Since it was implemented, the system has always been controversial. Physicians Apology System in different states are quite different in terms of content, form, time, and whether the object is only applicable to the claim, leading to physicians＇ refusal to apology for fear of legal risks, as well as issues such as forum shopping. However, both theoretical and empirical research data have shown that the system can indeed reduce the number of medical lawsuits, decrease the payment of medical injury claims, thereby easing the doctor-patient relationship. In order to play a better role, scholars have proposed amendments to Federal Rules of Evidence. Under the goal of building a harmonious doctor-patient relationship, the system and its impact on the evidence law deserve our study and reference.