关于我国输血感染损害责任的反思——《侵权责任法》实施前后对比

Reflection on Liability for Damage of Transfusion Infection in China——Before and after the Implementation of "The Law of Liability for Infringement"

《侵权责任法》实施前后,致司法实践中的相关判例对输血感染损害责任的认定存在差别。《侵权责任法》第五十九条规定由医疗机构和血液提供机构承担不真正连带责任,即准用产品责任,虽在很大程度上保护了作为弱势群体的患者利益,但也给医院和血站等公共服务机构带来巨大的经济负担。本文围绕血液及血液制品是否属于产品、医疗机构和血液提供者是否应承担产品责任、患者损害与输血行为之间的因果关系、其举证责任需如何分配、应当达到何种证明标准等焦点问题进行了深入分析,认为随着医疗改革"医药分家"制度的推行和基于公共医疗机构、血液提供机构的公益性质,针对输血感染致害应按照过错推定原则追究医方的责任;同时,鉴于医疗行为的专业性,举证责任也应在医患双方之间作出合理分配,不适用一般过错责任举证分配的规定;在此基础上,借鉴国外相关经验,提出了设立医疗强制责任险制度和赔偿基金等建议,以期为解决输血感染纠纷寻求良方。

Before and after the implementation of The Law of Liability for Infringement, there is a difference in relevant cases of the cognizance of damage liability of blood transfusion infection in judicial practice, in article 59 of The Law of Liability for Infringement, it is stipulated that the medical institutions and blood supply institutions should bear untrue joint compensation obligation, i.e. product application liability, which protects the interests of patients as a vulnerable group to a large extent, but brings huge economic burden to public service agencies such as the hospitals and blood stations at the same time. This article carried on a thorough analysis on the following focus： whether the blood and blood products belong to the product, whether medical institutions and blood providers should bear product liability, how to allocate the burden of proof of causal relationship between patients＂ damage and blood transfusion behavior, and what proof standards should be reached, etc.; suggested that with the implementation of the health care medicine separation system and based on the public welfare nature of public medical institutions and blood providing agencies, the liability of the damage caused by the blood transfusion infection should be called to account in accordance with the principle of fault presumption, And given the specialty of medical behaviors, the general provisions are not applicable, the burden of proof should also be reasonably allocated between patients and institutions. On this basis, by drawing lessons from foreign experiences, this paper put forward the suggestions of setting up medical system of compulsory liability insurance and compensation fund and so on, in order to better solve the disputes of blood transfusion infection.