《民法典》医疗过失判定规则的再解读

A Reinterpretation of the Medical Negligence Rules in the Civil Code

《民法典》对医疗过失判定规则修改的幅度不大,基本继受了《侵权责任法》的规定。我国以往对医疗过失判定规则的解释存在一定的问题,具体表现在部分条文的解释难以形成共识和部分条文的解释结论欠妥。在对医疗过失判定规则进行解释时应对其解释路径进行科学定位,然后才能对医疗过失判定的具体的规则进行正确的解读。衡量医疗过失的标准是医疗水平标准,而不是诊疗规范标准。违反诊疗规范应推定有过失。衡量医疗水平应考虑诊疗规范因素、地域因素、资质因素。我国《民法典》对证明困境下医疗过失的判定作出了特殊规定,学界对伪造、篡改病历等行为与医疗过失的关系存在争议,这些行为的存在应推定有医疗过失,医疗机构可以进行反证。

The civil Code does not modify the rules of medical negligence to a large extent,and is basically followed by the provisions of tort Liability Law.There are some problems in the interpretation of medical negligence rules in our country,which are manifested in the difficulty in forming a consensus in the interpretation of some articles and the inadequacies in the interpretation of some articles.In order to interpret the specific rules of medical negligence,we should scientifically position the interpretation path of the rules.The standard to measure medical negligence is the standard of medical treatment,not the standard of diagnosis and treatment.Violation of medical regulations should be presumed to be a fault.To measure the medical level,we should consider the factors of diagnosis and treatment standard,region and qualification.China's current law has made special provisions on the judgment of medical negligence in the case of proving difficulties,but the academic community has disputes on the relationship between forgery,tampering,medical records and medical negligence.The existence of these behaviors should be presumed to have medical negligence,and medical institutions can prove the contrary.