医疗损害鉴定的核心要点与进路解析——以SF/T 0097-2021标准为视角

Key points and approach analysis of medical damage forensic appraisal from the perspective of Standard SF/T 0097-2021

鉴定意见在医疗纠纷案件处理中具有重要的技术支撑作用,现阶段,我国亟需厘清医疗损害鉴定的理论与操作进路。本文系统梳理医疗损害鉴定的核心要点,并以SF/T 0097-2021《医疗损害司法鉴定指南》为视角,指出:医疗过错的评判原则、因果关系分析、医疗过错的原因力评定是医疗损害鉴定的核心要点。作者提出:(1)医疗过错的评判原则应以具体规定为基本标准,以注意义务为实务标准,以告知义务为伦理标准;(2)针对因果关系分析,需区分直接因果关系,复杂因果关系,相当因果关系等;(3)原因力的具体分类包括全部原因、主要原因、同等原因、次要原因、轻微原因及无原因。本文对上述三方面内容分别从标准条文、鉴定思路、操作要点层次清晰地给予了进路解析,力求厘清关键问题、构建科学的理论与操作模式,为司法鉴定提供有益的参考。

Forensic appraisal opinions play an important role in the verdicts of medical disputes.At present,it is very urgent to clarify the theories and approaches of the medical damage appraisal in China.This paper systematically reviewed the core aspects of medical damage appraisal and analyzed them through the lens of SF/T 0097-2021"Guidance for judicial expertise of medical malpractice".Three keypoints had been identified:the principles for evaluating medical malpractice,the causation analysis,and the assessment of causative potency in medical malpractice.To be specific:(1)Medical malpractice evaluation should take concrete provisions as the basis standard,duty of care as the practical standard,and informed consent as the ethical standard;(2)For the analysis of causality,it is necessary to distinguish between direct,complex and equivalent causalities;(3)The specific categorization of causality includes sole cause,primary cause,co-equal cause,secondary cause,minor cause and non-cause.This paper provides a clear elaboration of the above three aspects from the perspectives of standard clauses,appraisal methodology,and operational guidelines,aiming to elucidate the key issues,establish scientifically theoretical and operational models,and offer constructive references for forensic identification.