非法行医致人死亡的认定及量刑的实践检视

Practice Review on the Determination and Sentencing of Death Caused by Illegal Medical Practice

实务中难以区分非法行医致人死亡与过失致人死亡罪,根源在于未能厘清两者的关系。厘清关系的前提是区分非法行医罪的基本犯与结果加重犯,即明确司法解释中“直接、主要原因”的内涵。应当引入德国的“直接关联性”理论对因果关系进行限制。“直接原因”与“主要原因”是并列关系。只有造成就诊人死亡高度危险的医疗行为直接造成了死亡结果,且损害参与度超过50%,才可认为存在“直接性关联”,才能认定为“造成就诊人死亡”。非法行医罪与过失致人死亡罪应当是想象竞合的关系,在造成就诊人死亡的场合,以过失致人死亡罪定罪处罚,可以使非法行医致人死亡形成三个阶梯式的量刑档次,弥补现有法定刑隐形断层的缺陷,实现量刑均衡。

Where death is caused as a result of illegal medical practice,we should set a limit on the causality that results in the death of the person seeking medical service and adopt direct causality to identify aggregated consequential offense.For the judgment of the overlapping legal provisions on its special relations,we should stick to a dual observation of the logical relation and the identical legal interests.To have identical legal interests,not only do we require“identical quality”,but also“identical quantity”.Under this judgment standard,for the crime of illegal medical practice,there has been an imaginative joinder of offenses including the aggregated consequential offense and the crime of negligent homicide.Where there is no direct causality between illegal medical practice and death result,it should be punished for the crime of negligent homicide.In this way,we can make up for the defect--the“invisible fault”of the existing statutory sentence for this crime.