医疗美容纠纷中诈骗罪的边界

Boundary of the Crime of Fraud in Medical Cosmetology Disputes

由欺诈行为引发的医疗美容手术纠纷的受害者大多通过民事途径维护自身的合法权益,而该类欺诈行为也可能构成诈骗罪,如医疗美容机构篡改或者伪造主刀医生执业资格、职称,而使受害者陷入错误认识并处分了财产,便具备“欺诈”的基本构成要素;其在术前欺骗受害者签署与实际手术方案不符的手术知情同意书、以国产医疗器械冒充进口产品,骗取高额差价的行为,也符合诈骗罪的构成要件。而由于民事欺诈和刑事欺诈并不是排他的关系,故不能通过民事赔偿规避欺诈者所应当承担的刑事责任,而应在法益侵害的认定方面采用客观的经济损失学说,即诈骗金额为受害人实际支付的金额与所获得服务之间的差价;在认定行为是否构成医疗美容案件中的诈骗罪时,也要与故意伤害罪、非法行医罪、保险诈骗罪、医疗过失行为等相区别。

Victims in medical cosmetic surgery disputes caused by fraud mostly safeguard their legitimate rights and interests through civil channels,and such fraud may also constitute a crime of fraud.For example,medical cosmetic institutions tamper with or falsify the practicing qualification and professional title of leading doctors,so that victims fall into wrong understanding and dispose of their property,and they have the basic elements of"fraud".The behavior of deceiving the victim to sign the informed consent of the operation that is inconsistent with the actual operation plan before the operation,passing the domestic medical instruments as imported products,and defrauding the high price difference is also in line with the constitutive elements of the crime of fraud.Since civil fraud and criminal fraud are not exclusive,it is not possible to avoid the criminal liability of the fraudster through civil compen⁃sation,but the objective theory of economic loss should be adopted in the identification of legal interest infringement,that is,the amount of fraud is the difference between the actual amount paid by the victim and the service obtained.When determining whether the act constitutes the crime of fraud in the case of medical cosmetology,it should also be distinguished from the crime of intentional injury,the crime of illegal practice of medicine,the crime of insurance fraud,the act of medical negligence,etc.