基于信任评估理论的患者过失之认定

Identification of Patients'Fault Based on Trust Assessment Theory

信任在和谐的医患关系中起着基础性作用。医患信任理论经历了由信任推定理论的提出到与信任评估理论的协同,前者的核心是推定患者信任医生,弊端在于医患之间形成“上”与“下”而非平等关系;后者提高了患者的注意义务,促使患者行为符合一般理性人标准,使得医患关系平等化,且基于此理论,在医疗行为中患者负有一定的配合义务,若违反该义务即构成患者过失而理应减轻医疗机构责任。

Trust plays a fundamental role in harmonious doctor-patient relationship.Doctor-patient trust theo⁃ry has experienced the proposition of trust presumption theory and the coordination with trust assessment theory.The core of the former is the presumption that patients trust doctors,but the disadvantages lie in the vertical rather than equal relationship between doctors and patients.While the latter enhances the patients’duty of care,promotes the patients’behavior to conform to the general rational human standard,and makes the doctor-patient relationship equal.Based on this theory,the patients have a certain duty of cooperation in the medi⁃cal behaviors.If they violate this duty,it constitutes the patients’fault,and the responsibility of the medical institu⁃tions should be reduced.