多点远程执业模式对医师注意义务认定的挑战及其回应

The Challenge and Response of Multi-Point Remote Practice Mode to the Determination of Doctors' Duty of Care

多点远程执业模式以医师为主体,通过互联网技术为注册医师多点、线上执业提供了可能,但也对医师注意义务的认定带来挑战。在多点远程执业模式下,法律关系由简单变得复杂,诊疗场景由单一转向多变,主观医疗过错的判定由相对容易变得较为困难。在这种情况下,医患关系的成立节点、医师在不同情境下的具体诊疗义务以及各主体之间的责任分配规则等问题需要重新思考。医患关系是否存在之认定应以是否接受诊疗为关键判断因素,远程诊疗下应扩张解释医师的亲自诊查义务。各主体之间的责任分配以合同作为主要判断依据,如果不存在合同,则需要根据民法典中相关规定进行确定。

The multi-point remote practice mode takes physicians as the main body,which provides the possibility for registered physician to practice in different points and online through Internet technology,but it also brings challenges to the determination of physician's duty of care.In the multi-point remote practice mode,the legal relationship changes from simple to complex,the diagnosis and treatment scene changes from single to changeable,and the judgment of subjective medical fault turns from relatively easy to more difficult.In this case,the establishment time of the doctor-patient relationship,the specific diagnosis and treatment obligations of doctors in different situations and the rules of responsibility distribution among the subjects need to be reconsidered.Whether the doctor-patient relationship exists or not should be determined by whether or not to receive diagnosis and treatment.The physician's duty of personal diagnosis and examination should be expanded under remote diagnosis and treatment mode.The distribution of responsibility among the subjects should be based on the contract,and if there is no contract,it needs to be determined according to the relevant provisions of the Civil Code.