《医疗损害责任解释》司法适用实证研究

An Empirical Study on the Judicial Application of the Interpretation of Liability for Medical Damage

《医疗损害责任解释》主要对《侵权责任法》之医疗损害责任相关条款作了细化阐释;该解释颁行后的一年内,全国有28个省(市、自治区)的法院判决对其进行了引用,其中"举证责任分配""医疗损害鉴定程序"与"综合判断过错原则"条款被集中适用,并由此形成了"驳回推理公式"。其中,法官对于鉴定意见的依赖,有待通过完善审判组织等方式予以逐步减弱,通过法律援助等方式增强患方参与医疗损害鉴定的积极性,并须完善死亡患者尸检告知制度;再则,通过加强对申请重新鉴定的审查并引导当事人申请鉴定人出庭质证的方式,增加鉴定人出庭质证程序的启动,也可保障法官裁判更加公正;此外,增加医疗责任风险分担制度并引入诉讼,可以进一步增强判决的接受度。

The Interpretation of Medical Damage Liability elaborates and explains the relevant provisions of medical damage liability in Tort Liability Law from seven aspects.Within one year after the release of the interpretation,courts in 28 provinces and autonomous regions in China cited its provisions,among which mainly focus on the principles of"distribution of burden of proof","procedure of medical damage appraisal"and"principle of comprehensive judgment of fault",and thus formed the"rejection inference formula".The dependence of the judge on the appraisal opinion needs to be gradually weakened by improving the trial organization,enhancing the patient's enthusiasm to participate in the medical damage appraisal through legal aid,and improving the autopsy notification system for the deceased patients.On the other hand,by strengthening the review of the application for re-appraisal and guiding the parties to apply for cross-examination of the expert in court,cross-examination procedure of the expert in court can be started,it can also ensure that the judge is more just.In addition,by increasing the medical liability risk sharing system to introduce litigation,the acceptance of judgment can be further enhanced.