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主 講 人:最高人民法院研究室法官 汪治平
我wo隻zhi能neng就jiu我wo所suo了le解jie的de情qing況kuang給gei大da家jia介jie紹shao這zhe個ge大da的de問wen題ti當dang中zhong的de一yi個ge非fei常chang小xiao的de問wen題ti,我wo有you一yi個ge非fei常chang簡jian明ming的de提ti綱gang,我wo剛gang才cai跟gen部bu長chang商shang量liang了le一yi下xia,上shang午wu休xiu息xi之zhi前qian,把ba我wo們men起qi草cao的de通tong知zhi當dang中zhong設she計ji的de問wen題ti,或huo者zhe說shuo理li解jie的de問wen題ti的de一yi部bu分fen給gei大da家jia介jie紹shao一yi下xia,在zai休xiu息xi以yi後hou,我wo給gei大da家jia介jie紹shao兩liang方fang麵mian的de問wen題ti,一yi個ge是shi我wo們men目mu前qian二er人ren民min法fa院yuan正zheng在zai研yan究jiu的de,跟gen醫yi療liao糾jiu紛fen有you關guan係xi的de非fei典dian的de問wen題ti。但dan是shi非fei典dian的de問wen題ti並bing不bu是shi全quan國guo各ge地di都dou有you,而er且qie這zhe些xie糾jiu紛fen目mu前qian法fa院yuan受shou理li得de都dou非fei常chang少shao,但dan是shi這zhe是shi大da家jia都dou關guan注zhu問wen題ti。在zai中zhong間jian休xiu息xi以yi後hou的de時shi間jian,我wo看kan大da家jia提ti了le很hen多duo問wen題ti,那na麼me我wo試shi圖tu就jiu大da家jia提ti出chu的de問wen題ti,提ti出chu我wo個ge人ren的de看kan法fa。我wo在zai此ci需xu要yao先xian說shuo明ming一yi點dian,無wu論lun是shi我wo在zai前qian麵mian介jie紹shao的de和he後hou麵mian提ti出chu的de意yi見jian,完wan全quan是shi我wo個ge人ren的de看kan法fa和he意yi見jian。一yi方fang麵mian,到dao目mu前qian為wei止zhi,自zi去qu年nian國guo務wu院yuan出chu台tai醫yi療liao事shi故gu處chu理li條tiao例li以yi後hou,最zui高gao人ren民min法fa院yuan正zheng式shi的de文wen件jian隻zhi是shi發fa了le一yi個ge通tong知zhi,這zhe個ge大da家jia都dou看kan到dao了le,今jin年nian公gong布bu的de,按an照zhao我wo們men的de工gong作zuo安an排pai,除chu了le這zhe個ge通tong知zhi之zhi外wai,我wo們men院yuan裏li說shuo,院yuan領ling導dao已yi經jing同tong意yi,或huo者zhe說shuo要yao求qiu在zai就jiu人ren民min法fa院yuan審shen理li醫yi療liao糾jiu紛fen案an件jian使shi用yong法fa製zhi的de問wen題ti,提ti出chu一yi個ge正zheng式shi的de司si法fa解jie釋shi。就jiu是shi說shuo,在zai這zhe個ge通tong知zhi沒mei有you明ming確que問wen題ti或huo者zhe大da家jia所suo關guan心xin的de問wen題ti,可ke能neng會hui在zai以yi後hou的de正zheng式shi司si法fa解jie釋shi裏li麵mian,得de到dao比bi較jiao明ming確que的de解jie決jue。
按(an)照(zhao)我(wo)給(gei)大(da)家(jia)列(lie)名(ming)的(de)簡(jian)要(yao)提(ti)綱(gang),這(zhe)個(ge)簡(jian)要(yao)提(ti)綱(gang)主(zhu)要(yao)是(shi)圍(wei)繞(rao)我(wo)們(men)今(jin)年(nian)發(fa)的(de)這(zhe)個(ge)通(tong)知(zhi)。這(zhe)個(ge)通(tong)知(zhi)非(fei)常(chang)簡(jian)單(dan),這(zhe)個(ge)通(tong)知(zhi)隻(zhi)有(you)三(san)條(tiao),按(an)照(zhao)我(wo)們(men)院(yuan)的(de)分(fen)工(gong),其(qi)中(zhong)鑒(jian)定(ding)的(de)問(wen)題(ti)後(hou)麵(mian)會(hui)介(jie)紹(shao)到(dao),我(wo)上(shang)午(wu)不(bu)涉(she)及(ji)。賠(pei)償(chang)的(de)問(wen)題(ti),剛(gang)才(cai)有(you)一(yi)個(ge)同(tong)誌(zhi)跟(gen)我(wo)說(shuo),希(xi)望(wang)您(nin)能(neng)對(dui)醫(yi)療(liao)事(shi)故(gu)條(tiao)例(li),有(you)關(guan)醫(yi)療(liao)費(fei)的(de)計(ji)算(suan)問(wen)題(ti)做(zuo)出(chu)一(yi)個(ge)解(jie)釋(shi)。我(wo)想(xiang),那(na)個(ge)可(ke)能(neng)不(bu)是(shi)大(da)家(jia)最(zui)主(zhu)要(yao)關(guan)心(xin)的(de)問(wen)題(ti),大(da)家(jia)主(zhu)要(yao)關(guan)心(xin)的(de)問(wen)題(ti)就(jiu)是(shi),我(wo)們(men)這(zhe)個(ge)通(tong)知(zhi)裏(li)麵(mian)的(de)第(di)一(yi)條(tiao)的(de)第(di)一(yi)款(kuan)的(de)最(zui)後(hou)一(yi)句(ju)話(hua)。我(wo)試(shi)圖(tu)就(jiu)我(wo)的(de)理(li)解(jie)給(gei)大(da)家(jia)做(zuo)一(yi)個(ge)介(jie)紹(shao)。
我們在後邊都是與醫療糾紛 處(chu)理(li)有(you)關(guan)係(xi)的(de)同(tong)誌(zhi),大(da)家(jia)都(dou)知(zhi)道(dao),可(ke)能(neng)昨(zuo)天(tian)我(wo)們(men)國(guo)務(wu)院(yuan)法(fa)製(zhi)辦(ban)的(de)史(shi)司(si)長(chang)和(he)趙(zhao)司(si)長(chang)他(ta)們(men)都(dou)給(gei)你(ni)們(men)介(jie)紹(shao)了(le)條(tiao)例(li)出(chu)台(tai)的(de)前(qian)前(qian)後(hou)後(hou)。現(xian)在(zai)想(xiang)簡(jian)要(yao)介(jie)紹(shao)一(yi)下(xia),我(wo)們(men)這(zhe)個(ge)通(tong)知(zhi)出(chu)台(tai)的(de)簡(jian)要(yao)的(de)背(bei)景(jing)。可(ke)能(neng)大(da)家(jia)都(dou)會(hui)歸(gui)納(na)有(you)一(yi)個(ge)非(fei)常(chang)好(hao)的(de)現(xian)象(xiang)。在(zai)全(quan)國(guo)人(ren)大(da)常(chang)委(wei)會(hui)通(tong)過(guo)地(di)方(fang)法(fa)以(yi)後(hou),我(wo)們(men)國(guo)務(wu)院(yuan)在(zai)製(zhi)定(ding)行(xing)政(zheng)法(fa)規(gui)的(de)時(shi)候(hou),它(ta)已(yi)經(jing)非(fei)常(chang)注(zhu)意(yi)到(dao),就(jiu)是(shi)說(shuo),行(xing)政(zheng)法(fa)規(gui)它(ta)所(suo)涉(she)及(ji)的(de)事(shi)項(xiang),主(zhu)要(yao)包(bao)括(kuo)兩(liang)個(ge)方(fang)麵(mian)。第(di)一(yi)個(ge)問(wen)題(ti),為(wei)執(zhi)行(xing)法(fa)律(lv)而(er)需(xu)要(yao)規(gui)定(ding)的(de)事(shi)項(xiang),或(huo)者(zhe)為(wei)執(zhi)行(xing)法(fa)律(lv),而(er)需(xu)要(yao)政(zheng)府(fu)機(ji)關(guan)具(ju)體(ti)實(shi)施(shi)的(de)事(shi)項(xiang),另(ling)外(wai)行(xing)政(zheng)法(fa)規(gui)主(zhu)要(yao)是(shi)規(gui)定(ding)有(you)關(guan)行(xing)政(zheng)管(guan)理(li)方(fang)麵(mian)的(de)事(shi)項(xiang)。換(huan)句(ju)話(hua)說(shuo),在(zai)地(di)方(fang)法(fa)出(chu)台(tai)以(yi)後(hou),國(guo)務(wu)院(yuan)在(zai)製(zhi)定(ding)行(xing)政(zheng)法(fa)規(gui)的(de)時(shi)候(hou),對(dui)於(yu)涉(she)及(ji)到(dao)民(min)事(shi)糾(jiu)紛(fen)的(de)處(chu)理(li),或(huo)者(zhe)是(shi)涉(she)及(ji)到(dao)人(ren)民(min)法(fa)院(yuan)工(gong)作(zuo)的(de)時(shi)候(hou),通(tong)常(chang)是(shi)不(bu)做(zuo)規(gui)定(ding)的(de)。或(huo)者(zhe)最(zui)多(duo)隻(zhi)做(zuo)一(yi)個(ge)銜(xian)接(jie)性(xing)的(de)規(gui)定(ding)。那(na)麼(me)我(wo)個(ge)人(ren)覺(jiao)得(de),這(zhe)是(shi)一(yi)個(ge)非(fei)常(chang)好(hao)的(de)文(wen)件(jian),因(yin)為(wei)已(yi)經(jing)是(shi)按(an)照(zhao)我(wo)們(men)中(zhong)國(guo)目(mu)前(qian)憲(xian)法(fa)的(de)分(fen)工(gong),政(zheng)府(fu)的(de)事(shi)情(qing)或(huo)法(fa)律(lv)的(de)事(shi)情(qing)是(shi)完(wan)全(quan)不(bu)同(tong)的(de)性(xing)質(zhi)。在(zai)這(zhe)樣(yang)的(de)情(qing)況(kuang)下(xia),行(xing)政(zheng)法(fa)規(gui)隻(zhi)規(gui)定(ding)應(ying)當(dang)規(gui)定(ding)的(de)事(shi)項(xiang)。我(wo)之(zhi)所(suo)以(yi)解(jie)釋(shi)這(zhe)個(ge)問(wen)題(ti),就(jiu)是(shi)我(wo)們(men)在(zai)以(yi)前(qian)很(hen)多(duo)的(de)行(xing)政(zheng)法(fa)規(gui)裏(li)麵(mian),它(ta)實(shi)際(ji)上(shang)完(wan)全(quan)超(chao)出(chu)了(le)行(xing)政(zheng)管(guan)理(li)的(de)事(shi)項(xiang),它(ta)在(zai)我(wo)們(men)過(guo)去(qu)的(de)合(he)同(tong)法(fa),就(jiu)是(shi)經(jing)濟(ji)合(he)同(tong)法(fa)出(chu)台(tai)以(yi)後(hou),國(guo)務(wu)院(yuan)就(jiu)製(zhi)定(ding)了(le)很(hen)多(duo)的(de)單(dan)行(xing)的(de)合(he)同(tong)條(tiao)例(li),這(zhe)些(xie)合(he)同(tong)條(tiao)例(li),完(wan)全(quan)是(shi)一(yi)種(zhong)解(jie)決(jue)民(min)事(shi)糾(jiu)紛(fen)的(de),或(huo)者(zhe)是(shi)規(gui)範(fan)民(min)事(shi)關(guan)係(xi)的(de)東(dong)西(xi)。那(na)麼(me)這(zhe)種(zhong)民(min)事(shi)關(guan)係(xi),按(an)照(zhao)憲(xian)法(fa)或(huo)三(san)個(ge)訴(su)訟(song),特(te)別(bie)是(shi)民(min)事(shi)訴(su)訟(song)法(fa)的(de)分(fen)工(gong),這(zhe)種(zhong)關(guan)係(xi),應(ying)該(gai)由(you)立(li)法(fa)來(lai)解(jie)決(jue),這(zhe)種(zhong)糾(jiu)紛(fen)應(ying)該(gai)由(you)法(fa)院(yuan)處(chu)理(li)。在(zai)立(li)法(fa)法(fa)製(zhi)以(yi)後(hou),這(zhe)種(zhong)情(qing)況(kuang)已(yi)經(jing)改(gai)變(bian)了(le)。
yiliaojiufen,wulunshiwomenmuqianduiyihuanguanxi,dajiadouzaizhenglun,daodishiyizhonghetongguanxi,haishiyizhongfuwuguanxi。zhegesuiranshuogeyoubutongdekanfa,erqiemeiyizhongkanfa,wodoujiaodefeichangyoudaoli。danshi,danshiwulunshiyizhonghetongguanxihaishiyizhongfuwuguanxi,tadegenbenxingzhi,huozheshuozuituchudetedianshiyizhongminshiguanxi,namezhemeyizhongminshiguanxiyinggaiyoulifalaiguifan,erbuyingdangyouxingzhengfaguilaiguifan,yourenshuogenjuxianfa98條,有關國務院製定,或者有關國務院可以製定法規的行政範圍來看,國務院和行政法規可以涉及到任何一個方麵。但是在82年nian的de時shi候hou,憲xian法fa起qi草cao當dang中zhong,因yin為wei涉she及ji到dao當dang時shi的de情qing況kuang而er製zhi定ding的de,但dan是shi從cong全quan國guo人ren民min服fu務wu,對dui政zheng府fu部bu門men,或huo者zhe是shi行xing政zheng機ji關guan,或huo者zhe是shi司si法fa部bu門men對dui關guan係xi的de分fen工gong,已yi經jing走zou到dao一yi個ge大da家jia都dou公gong認ren的de看kan法fa當dang中zhong。行xing政zheng機ji關guan的de事shi情qing,就jiu是shi司si法fa機ji關guan的de事shi情qing是shi兩liang種zhong不bu同tong性xing質zhi的de事shi情qing。
行(xing)政(zheng)醫(yi)療(liao)糾(jiu)紛(fen),不(bu)管(guan)它(ta)進(jin)行(xing)一(yi)種(zhong)活(huo)動(dong)關(guan)係(xi)還(hai)是(shi)服(fu)務(wu)關(guan)係(xi),都(dou)是(shi)民(min)事(shi)關(guan)係(xi),那(na)麼(me)民(min)事(shi)關(guan)係(xi)都(dou)應(ying)該(gai)有(you)立(li)法(fa)的(de)規(gui)定(ding),民(min)事(shi)糾(jiu)紛(fen)應(ying)該(gai)由(you)司(si)法(fa)來(lai)出(chu)裁(cai)決(jue)或(huo)者(zhe)是(shi)處(chu)理(li)。當(dang)然(ran)民(min)事(shi)糾(jiu)紛(fen)由(you)法(fa)院(yuan)或(huo)者(zhe)司(si)法(fa)機(ji)關(guan)處(chu)理(li)裁(cai)舉(ju)指(zhi)的(de)是(shi)司(si)法(fa)機(ji)關(guan)或(huo)者(zhe)是(shi)法(fa)院(yuan)在(zai)對(dui)民(min)事(shi)糾(jiu)紛(fen)依(yi)法(fa)享(xiang)有(you)最(zui)終(zhong)的(de)處(chu)理(li)權(quan)利(li),並(bing)不(bu)是(shi)說(shuo)政(zheng)府(fu)機(ji)關(guan)或(huo)者(zhe)行(xing)政(zheng)機(ji)關(guan),或(huo)者(zhe)其(qi)他(ta)機(ji)關(guan)在(zai)解(jie)決(jue)民(min)事(shi)糾(jiu)紛(fen)的(de)時(shi)候(hou),那(na)完(wan)全(quan)是(shi)不(bu)可(ke)作(zuo)為(wei)。不(bu)是(shi)這(zhe)個(ge)意(yi)思(si)。
那na麼me這zhe種zhong理li解jie,同tong時shi我wo們men在zai各ge區qu,大da家jia都dou對dui國guo務wu院yuan原yuan來lai的de醫yi療liao事shi故gu處chu理li辦ban法fa,有you很hen多duo的de看kan法fa的de時shi候hou,或huo者zhe說shuo有you很hen多duo負fu麵mian的de評ping價jia的de時shi候hou,昨zuo天tian我wo想xiang跟gen國guo務wu院yuan法fa製zhi辦ban的de同tong誌zhi和he衛wei生sheng部bu的de同tong誌zhi說shuo,在zai這zhe個ge條tiao例li出chu台tai之zhi前qian,每mei年nian的de兩liang會hui期qi間jian,或huo者zhe是shi其qi他ta的de時shi候hou,都dou會hui有you大da量liang的de人ren大da代dai表biao,或huo者zhe是shi政zheng協xie委wei員yuan提ti出chu議yi案an,要yao求qiu改gai變bian這zhe個ge國guo務wu院yuan的de醫yi療liao事shi故gu處chu理li辦ban法fa所suo規gui定ding的de醫yi療liao糾jiu紛fen的de這zhe種zhong解jie決jue辦ban法fa。
因(yin)為(wei)醫(yi)療(liao)事(shi)故(gu)處(chu)理(li)條(tiao)例(li),我(wo)在(zai)製(zhi)定(ding)過(guo)程(cheng)當(dang)中(zhong),法(fa)學(xue)院(yuan)的(de)有(you)關(guan)部(bu)門(men)一(yi)致(zhi)參(can)與(yu)這(zhe)個(ge)事(shi)情(qing),本(ben)人(ren)作(zuo)為(wei)具(ju)體(ti)的(de)工(gong)作(zuo)人(ren)員(yuan),曾(zeng)經(jing)也(ye)參(can)與(yu)過(guo),但(dan)就(jiu)我(wo)所(suo)知(zhi)道(dao)的(de)情(qing)況(kuang),原(yuan)來(lai)是(shi)希(xi)望(wang)由(you)全(quan)國(guo)人(ren)大(da)常(chang)委(wei)會(hui)來(lai)就(jiu)醫(yi)療(liao)事(shi)故(gu)處(chu)理(li)做(zuo)出(chu)立(li)法(fa),但(dan)是(shi)考(kao)慮(lv)到(dao)這(zhe)個(ge)問(wen)題(ti)的(de)複(fu)雜(za)性(xing),以(yi)及(ji)在(zai)這(zhe)樣(yang)的(de)情(qing)況(kuang)下(xia),認(ren)為(wei),目(mu)前(qian)製(zhi)定(ding)法(fa)律(lv)尚(shang)不(bu)成(cheng)熟(shu),有(you)國(guo)務(wu)院(yuan)製(zhi)定(ding)行(xing)政(zheng)法(fa)規(gui)以(yi)及(ji)的(de)經(jing)驗(yan),然(ran)後(hou)再(zai)上(shang)升(sheng)到(dao)法(fa)令(ling)。在(zai)這(zhe)樣(yang)一(yi)個(ge)背(bei)景(jing)下(xia),國(guo)務(wu)院(yuan)出(chu)台(tai)了(le)一(yi)個(ge)治(zhi)療(liao)事(shi)故(gu)處(chu)理(li)條(tiao)例(li),但(dan)是(shi)這(zhe)個(ge)醫(yi)療(liao)事(shi)故(gu)處(chu)理(li)條(tiao)例(li),雖(sui)然(ran)說(shuo),它(ta)在(zai)性(xing)質(zhi)上(shang)是(shi)行(xing)政(zheng)法(fa)規(gui),而(er)且(qie)它(ta)在(zai)內(nei)容(rong)上(shang),大(da)家(jia)都(dou)會(hui)看(kan)到(dao),很(hen)多(duo)的(de)內(nei)容(rong)是(shi)規(gui)定(ding)衛(wei)生(sheng)行(xing)政(zheng)主(zhu)管(guan)部(bu)門(men)在(zai)處(chu)理(li)醫(yi)療(liao)事(shi)故(gu)當(dang)中(zhong),應(ying)當(dang)遵(zun)循(xun)的(de)各(ge)種(zhong)規(gui)範(fan)。但(dan)是(shi),如(ru)果(guo)我(wo)們(men)僅(jin)僅(jin)是(shi)做(zuo)這(zhe)樣(yang)的(de)理(li)解(jie)的(de)話(hua),那(na)麼(me)這(zhe)個(ge)條(tiao)例(li)的(de)出(chu)台(tai),這(zhe)個(ge)醫(yi)療(liao)糾(jiu)紛(fen)的(de)處(chu)理(li)和(he)解(jie)決(jue),作(zuo)用(yong)非(fei)常(chang)有(you)限(xian)。那(na)麼(me)在(zai)這(zhe)樣(yang)一(yi)個(ge)背(bei)景(jing)下(xia),為(wei)了(le)使(shi)衛(wei)生(sheng)行(xing)政(zheng)主(zhu)管(guan)部(bu)門(men)通(tong)過(guo)行(xing)政(zheng)途(tu)徑(jing)處(chu)理(li)醫(yi)療(liao)事(shi)故(gu),或(huo)者(zhe)處(chu)理(li)醫(yi)療(liao)糾(jiu)紛(fen),和(he)人(ren)民(min)法(fa)院(yuan)在(zai)裁(cai)判(pan)醫(yi)療(liao)糾(jiu)紛(fen)或(huo)者(zhe)是(shi)民(min)事(shi)審(shen)判(pan)的(de)賠(pei)償(chang)糾(jiu)紛(fen)當(dang)中(zhong),能(neng)夠(gou)協(xie)調(tiao)一(yi)致(zhi)。那(na)麼(me)在(zai)這(zhe)個(ge)條(tiao)例(li)製(zhi)定(ding)過(guo)程(cheng)當(dang)中(zhong),最(zui)高(gao)人(ren)民(min)法(fa)院(yuan)和(he)國(guo)務(wu)院(yuan)的(de)領(ling)導(dao)就(jiu)達(da)成(cheng)了(le)一(yi)個(ge)默(mo)契(qi)。
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按(an)照(zhao)我(wo)們(men)起(qi)草(cao)這(zhe)個(ge)通(tong)知(zhi),以(yi)及(ji)起(qi)草(cao)這(zhe)個(ge)通(tong)知(zhi)之(zhi)前(qian),有(you)關(guan)領(ling)導(dao)的(de)意(yi)見(jian),所(suo)謂(wei)參(can)照(zhao),我(wo)的(de)理(li)解(jie)是(shi),人(ren)民(min)法(fa)院(yuan)在(zai)審(shen)理(li)醫(yi)療(liao)事(shi)故(gu)引(yin)起(qi)的(de)民(min)事(shi)審(shen)判(pan)的(de)這(zhe)場(chang)糾(jiu)紛(fen)。這(zhe)是(shi)按(an)照(zhao)這(zhe)個(ge)條(tiao)例(li)的(de)規(gui)定(ding),或(huo)者(zhe)按(an)照(zhao)條(tiao)例(li)的(de)規(gui)定(ding)來(lai)處(chu)理(li)。這(zhe)是(shi)我(wo)的(de)理(li)解(jie)。大(da)家(jia)都(dou)會(hui)注(zhu)意(yi)到(dao),我(wo)們(men)在(zai)行(xing)政(zheng)訴(su)訟(song)法(fa),有(you)關(guan)人(ren)民(min)法(fa)審(shen)理(li)行(xing)政(zheng)案(an)件(jian),參(can)照(zhao)規(gui)章(zhang)的(de)這(zhe)個(ge)規(gui)定(ding)的(de)時(shi)候(hou),那(na)個(ge)時(shi)候(hou),寫(xie)的(de)參(can)照(zhao)指(zhi)的(de)是(shi)一(yi)項(xiang)規(gui)章(zhang)他(ta)尚(shang)未(wei)規(gui)範(fan)的(de)時(shi)候(hou),法(fa)院(yuan)通(tong)常(chang)不(bu)會(hui)使(shi)用(yong)這(zhe)個(ge)規(gui)章(zhang)。但(dan)是(shi)我(wo)們(men)在(zai)這(zhe)個(ge)條(tiao)例(li)裏(li)麵(mian),就(jiu)會(hui)發(fa)現(xian),如(ru)果(guo)是(shi)做(zuo)這(zhe)種(zhong)理(li)解(jie)的(de)話(hua),讓(rang)我(wo)們(men)解(jie)決(jue)問(wen)題(ti)就(jiu)會(hui)引(yin)起(qi)更(geng)大(da)的(de)爭(zheng)議(yi)。因(yin)為(wei)我(wo)們(men)現(xian)在(zai)的(de)醫(yi)療(liao)事(shi)故(gu)條(tiao)例(li),它(ta)並(bing)沒(mei)有(you)原(yuan)引(yin)它(ta)的(de)立(li)法(fa)依(yi)據(ju),也(ye)就(jiu)是(shi)說(shuo),它(ta)並(bing)不(bu)是(shi)依(yi)據(ju)民(min)法(fa)通(tong)則(ze),幾(ji)乎(hu)是(shi)依(yi)據(ju)別(bie)人(ren),就(jiu)是(shi)衛(wei)生(sheng)管(guan)理(li)方(fang)麵(mian)的(de)法(fa)律(lv)製(zhi)定(ding)的(de)。那(na)我(wo)們(men)從(cong)這(zhe)個(ge)醫(yi)療(liao)事(shi)故(gu)處(chu)理(li)條(tiao)件(jian)第(di)一(yi)點(dian)就(jiu)看(kan)到(dao),他(ta)們(men)沒(mei)有(you)講(jiang)明(ming)他(ta)的(de)上(shang)麵(mian)的(de)法(fa)律(lv)。但(dan)是(shi)從(cong)我(wo)剛(gang)才(cai)談(tan)到(dao)的(de),醫(yi)療(liao)關(guan)係(xi),或(huo)者(zhe)是(shi)醫(yi)患(huan)關(guan)係(xi),或(huo)者(zhe)是(shi)醫(yi)療(liao)當(dang)中(zhong)的(de)糾(jiu)紛(fen)上(shang),如(ru)果(guo)把(ba)醫(yi)療(liao)糾(jiu)紛(fen)定(ding)義(yi)為(wei)民(min)事(shi)糾(jiu)紛(fen),當(dang)然(ran)醫(yi)患(huan)關(guan)係(xi)還(hai)有(you)各(ge)種(zhong)糾(jiu)紛(fen)。對(dui)民(min)事(shi)爭(zheng)議(yi)的(de)處(chu)理(li),我(wo)們(men)國(guo)家(jia)目(mu)前(qian)的(de)基(ji)本(ben)法(fa)律(lv)就(jiu)是(shi)民(min)法(fa)通(tong)則(ze)。這(zhe)是(shi)參(can)照(zhao)的(de)理(li)解(jie)不(bu)能(neng)像(xiang)對(dui)行(xing)政(zheng)訴(su)訟(song)法(fa)參(can)照(zhao)規(gui)章(zhang)的(de)比(bi)較(jiao)參(can)照(zhao)的(de)文(wen)化(hua)一(yi)樣(yang),如(ru)果(guo)是(shi)按(an)照(zhao)這(zhe)個(ge)理(li)解(jie)的(de)話(hua),那(na)麼(me)我(wo)們(men)這(zhe)個(ge)就(jiu)會(hui)在(zai)處(chu)理(li)醫(yi)療(liao)糾(jiu)紛(fen)的(de)時(shi)候(hou)會(hui)出(chu)現(xian)很(hen)多(duo)問(wen)題(ti)。我(wo)個(ge)人(ren)理(li)解(jie),我(wo)們(men)說(shuo)的(de)參(can)照(zhao)實(shi)際(ji)上(shang)就(jiu)是(shi)適(shi)用(yong)的(de)意(yi)思(si)。
第(di)二(er)個(ge)小(xiao)問(wen)題(ti),涉(she)及(ji)到(dao)對(dui)我(wo)們(men)這(zhe)個(ge)條(tiao)例(li),這(zhe)個(ge)通(tong)知(zhi)的(de)一(yi)些(xie)基(ji)本(ben)問(wen)題(ti)的(de)理(li)解(jie)。我(wo)們(men)的(de)通(tong)知(zhi)非(fei)常(chang)簡(jian)單(dan),一(yi)共(gong)是(shi)三(san)條(tiao),這(zhe)個(ge)通(tong)知(zhi)規(gui)定(ding)說(shuo),國(guo)務(wu)院(yuan)公(gong)布(bu)醫(yi)療(liao)事(shi)故(gu)處(chu)理(li)條(tiao)例(li)以(yi)後(hou),人(ren)民(min)法(fa)院(yuan)應(ying)當(dang)側(ce)重(zhong)這(zhe)個(ge)條(tiao)例(li)來(lai)審(shen)理(li)醫(yi)療(liao)糾(jiu)紛(fen)民(min)事(shi)案(an)件(jian)。其(qi)中(zhong)第(di)一(yi)條(tiao)規(gui)定(ding)說(shuo),條(tiao)例(li)實(shi)行(xing)後(hou)發(fa)生(sheng)的(de)醫(yi)療(liao)事(shi)故(gu)引(yin)起(qi)的(de)醫(yi)療(liao)賠(pei)償(chang)糾(jiu)紛(fen),訴(su)訟(song)到(dao)法(fa)院(yuan)的(de)參(can)照(zhao)條(tiao)例(li)的(de)有(you)關(guan)規(gui)定(ding)辦(ban)理(li),除(chu)醫(yi)療(liao)事(shi)故(gu)以(yi)外(wai)的(de)原(yuan)因(yin)引(yin)起(qi)的(de)其(qi)他(ta)醫(yi)療(liao)賠(pei)償(chang)糾(jiu)紛(fen)是(shi)用(yong)民(min)法(fa)通(tong)則(ze)的(de)規(gui)定(ding),人(ren)民(min)法(fa)院(yuan)在(zai)條(tiao)例(li)實(shi)行(xing)前(qian)已(yi)經(jing)按(an)照(zhao)民(min)法(fa)通(tong)則(ze),醫(yi)療(liao)事(shi)故(gu)處(chu)理(li)辦(ban)法(fa)與(yu)法(fa)律(lv)法(fa)規(gui)審(shen)計(ji)的(de)民(min)事(shi)案(an)件(jian)依(yi)法(fa)進(jin)行(xing)再(zai)審(shen)的(de)過(guo)程(cheng)中(zhong)符(fu)合(he)條(tiao)例(li)的(de)規(gui)定(ding)。
zhegetongzhishijishangtayouyigehexinwenti,yeshizhengquelijiezhegetongzhijingshenyigeguanjianwenti。yeshiyinqizhengyideyigewenti。diyitiaodeneirongshijishangbaokuoliangfangmiandeneirong。diyifangmiandeneirongjiushishuo,fayuanzaishenliyiliaojiufenpeichanganjiandeshihou,canzhaotiaolichulishiyigeshijianxiaolvdewenti,suiranguidingshuo,tiaolishixinghoufashengdeyiliaoshiguyinqideyiliaojiufenpeichanganjiansusongdaofayuandecanzhaotiaoliguidingdengdeng,danshijishang,zhegetongzhishiyiliaoshigufashengdeshijianerbushiyijiufenfashengdeshijian。zuoweicanzhaotiaolideanjiandangzhong。
anzhaowomenyiliaoshiguchulitiaolidiertiaodeguiding。yiliaoshigushizhiyiliaojigoujiqiyiwurenyuanzaochenghuanzhederenshensunhaideshigu,zhegeshigushijishangshiyigekeguandecuowu,shigubenshenshiyigeyiwaidebiangu,huozheshiqitadehouguo。suoyiwolijiezhegeyiliaoxingwei,panduanshenmeshihoushiyongzhegetiaoli,wojiaodeyinggaiyi2002年9月1號hao這zhe個ge條tiao例li實shi施shi前qian後hou,醫yi療liao活huo動dong或huo者zhe醫yi療liao行xing為wei作zuo為wei一yi個ge判pan斷duan標biao準zhun。雖sui然ran說shuo醫yi療liao行xing為wei,醫yi療liao事shi故gu實shi際ji上shang是shi一yi個ge前qian因yin後hou果guo的de關guan係xi,也ye就jiu是shi說shuo,隻zhi有you有you醫yi療liao行xing為wei,或huo者zhe是shi醫yi療liao活huo動dong,才cai可ke能neng產chan生sheng醫yi療liao事shi故gu。但dan是shi考kao慮lv到dao就jiu是shi說shuo,無wu論lun是shi行xing政zheng法fa規gui,還hai是shi其qi他ta的de規gui範fan,我wo們men都dou是shi對dui行xing為wei的de規gui範fan,而er且qie作zuo為wei通tong常chang的de法fa理li,認ren為wei,一yi個ge法fa律lv,除chu非fei法fa律lv有you特te別bie明ming確que的de規gui定ding之zhi外wai,法fa律lv本ben身shen包bao括kuo,我wo認ren為wei這zhe個ge法fa律lv具ju有you行xing政zheng法fa規gui,他ta不bu應ying當dang具ju有you這zhe個ge效xiao力li。所suo以yi我wo們men在zai這zhe個ge通tong知zhi裏li麵mian所suo提ti到dao的de這zhe個ge醫yi療liao事shi故gu,就jiu是shi說shuo,9月1hao,zhegetiaolishixinghoufashengdeyiliaoshigu,wogerenlijie,yinggaizhideshitiaolishixinghoudeyiliaoxingweichanshengdeyiliaoshigu。erbushishuoyiliaoxingweizaizhegetiaolishishizhiqian,nameyiliaoshiguzaizhegetiaolishishizhihou。yinwei8yuefendeyiliaoxingwei。nameyinweishigushiyichanghouguo,zhegehouguokenengtabunenglijixianxianchulai,huozheshibunengbiaoxianchulai。tazhinengshijingguoyidingdeshijian。chulelijibiaoxianchulai,tongchanghuiyouyigejindu。
suoyiwojiaode,ruguoshizaiyizhegepanduanshenmeshihoushiyongtiaoli,yiyiliaoxingweilaipanduan,kenengbiyiliaoshigulaipanduangenghuoyixie。zaizheyangdeqingkuangxia,fanshigetiaolishishizhihoudeyiliaoxingwei,suoyinqideyiliaoshigu,jiuanzhaozhegetiaolideguidinglaichuli。zaizhegetiaolishishizhiqiandeyiliaoxingwei,chanshengdeyiliaoshigu,yinqidejiufen,haishianzhaoyuanlaideguidinglaichuli。
zongzhi,yigeyiliaoxingweiheyigeyiliaoshiguheyiliaojiufen,tashizhesangezhijiandoushiyigeqianyinhouguo,xianghuzhijian,doushiyouyidingdejiangede。weishenmeyaoshuomingzhegewentine?womenzaitongzhitaolundeguochengdangzhong,huozhetongzhichuxianyihou,jingchangyouzhezhongqingkuang,dadianhuawen,zaitiaolishishizhiqiandezhezhongyiliaoxingwei,huozheshiyiliaoshigu,huozheshijiufen,tiaolishishizhihou,caisusongdaofayuan,zaizheyangdeqingkuangxia,kebukeyianzhaotiaolideguidingjinxing。huozheshuozaitiaolishishizhiqian,fayuanyijingchuliguo,huozheshiweishengzhuguanbumenyijingchuliguo,zaitiaolishishizhihou,zaicidaofayuannengbunenganzhaoyuanlaideguidingchuli,huozheshihoulaidetiaolilaichuli,wodekanfashi,fanshizaitiaolishishizhiqian,wulunshizhegejiufen,huozheshizhegezhengyi,youmeiyouyigeyouzuizhongdechulijieguo。wojiaode,douyingdanganzhaotiaolishishizhiqiandefalv,huozheshuoquanlishishizhiqiandezuofalaichuli。zheyoushitiaolishishiyihoudeyiliaoxingwei,suochanshengdeyiliaoshigu,huozheshuoyiliaozhengyi。namecaianzhaozhegetiaoliguidinglaijinxing。
這(zhe)裏(li)涉(she)及(ji)到(dao)一(yi)個(ge)方(fang)麵(mian),因(yin)為(wei)在(zai)按(an)照(zhao)醫(yi)療(liao)事(shi)故(gu)處(chu)理(li)辦(ban)法(fa)和(he)按(an)照(zhao)醫(yi)療(liao)事(shi)故(gu)處(chu)理(li)條(tiao)例(li)以(yi)及(ji)按(an)照(zhao)民(min)法(fa)通(tong)則(ze),這(zhe)三(san)個(ge)不(bu)同(tong)的(de)規(gui)範(fan)性(xing)文(wen)件(jian)處(chu)理(li)的(de)結(jie)果(guo)是(shi)完(wan)全(quan)不(bu)同(tong)的(de)。那(na)麼(me)大(da)家(jia)都(dou)知(zhi)道(dao),按(an)照(zhao)醫(yi)療(liao)事(shi)故(gu)處(chu)理(li)辦(ban)法(fa),走(zou)醫(yi)療(liao)事(shi)故(gu)鑒(jian)定(ding)委(wei)員(yuan)會(hui)漸(jian)進(jin)這(zhe)個(ge)途(tu)徑(jing)或(huo)者(zhe)是(shi)手(shou)段(duan)的(de)話(hua),它(ta)即(ji)使(shi)被(bei)鑒(jian)定(ding)為(wei)醫(yi)療(liao)事(shi)故(gu),那(na)麼(me)患(huan)者(zhe)所(suo)得(de)到(dao)的(de)賠(pei)償(chang)是(shi)非(fei)常(chang)有(you)效(xiao)的(de)。那(na)麼(me)按(an)照(zhao)這(zhe)個(ge)條(tiao)例(li)的(de)規(gui)定(ding)的(de)話(hua),雖(sui)然(ran)說(shuo),我(wo)們(men)這(zhe)個(ge)條(tiao)例(li)裏(li)麵(mian),對(dui)這(zhe)個(ge)賠(pei)償(chang)原(yuan)則(ze)采(cai)取(qu)的(de)是(shi)一(yi)個(ge)限(xian)額(e)賠(pei)償(chang)的(de)原(yuan)則(ze)。仍(reng)然(ran)他(ta)得(de)到(dao)的(de)賠(pei)償(chang)數(shu)額(e),應(ying)當(dang)按(an)照(zhao)醫(yi)療(liao)事(shi)故(gu)處(chu)理(li)辦(ban)法(fa),所(suo)規(gui)定(ding)的(de)方(fang)法(fa),處(chu)理(li)結(jie)果(guo)數(shu)額(e)要(yao)高(gao)。
nameruguoshianzhaominfatongzedeguidinglaichulidehua,nametagengxiangchahenduo。minfatongzecongwomenmuqiandetiaolihan,tacaiqudeshiquanbudeyuanze,bushiyigexianedeyuanze,zuigaorenminsifajieshibaokuominfatongzedeyouguantiaowen,keyidechuyigexianepeichang,huozheshipeichangshoudaoxianzhidezhemeyigejielunzhiwai,danshitadepeichangjibenshangshibucaiquxianzhipeichangzerende。zheshipeichangshuefangmian。lingwaiyige,jiushijianjinchengxu,qianhoudefaguifalvshixiangchahendade。anzhaoyiqiandeyiliaoshiguchulibanfa,tazoudeshiyizhongjibenshangshixingzhengchulidezhegetongji。anzhaowomenzuigaorenminfayuandexiangguandesifajieshiguiding,nameduiyuyiqian,yiliaoshiguchulibanfadeyiliaojiandingjielunshu,tashiyizhongxingzhengsusong,erbushiminshisusong,nameanzhaominshifalvtiqidejiushiyichangminshisusong。zheliangzhongjiandingchengxushiwanquanbutongde。dangrananzhaowomenxianzaideyiliaoshiguchulitiaoli,youyixuehuizuzhijianding,tayoushiyizhongbutongdejiandingchengxu。
所(suo)以(yi)在(zai)鑒(jian)定(ding),前(qian)後(hou)差(cha)別(bie)很(hen)大(da)。這(zhe)是(shi)時(shi)效(xiao)問(wen)題(ti)。第(di)二(er)個(ge),涉(she)及(ji)到(dao)另(ling)外(wai)一(yi)個(ge)問(wen)題(ti),關(guan)於(yu)各(ge)區(qu)的(de)情(qing)況(kuang),人(ren)民(min)法(fa)律(lv)在(zai)條(tiao)例(li)實(shi)行(xing)前(qian),已(yi)經(jing)按(an)照(zhao)有(you)關(guan)規(gui)定(ding)審(shen)行(xing)這(zhe)個(ge)案(an)子(zi),進(jin)行(xing)再(zai)審(shen)的(de)時(shi)候(hou),這(zhe)是(shi)司(si)法(fa)解(jie)釋(shi)一(yi)般(ban)的(de)原(yuan)因(yin)。我(wo)們(men)的(de)司(si)法(fa)解(jie)釋(shi)除(chu)非(fei)一(yi)些(xie)純(chun)粹(cui)是(shi)訴(su)訟(song)程(cheng)序(xu)方(fang)麵(mian)的(de)規(gui)定(ding)之(zhi)外(wai),其(qi)他(ta)的(de)實(shi)際(ji)上(shang),當(dang)事(shi)人(ren)實(shi)體(ti)民(min)事(shi)權(quan)利(li)的(de)司(si)法(fa)解(jie)釋(shi),通(tong)常(chang)是(shi)不(bu)適(shi)用(yong)於(yu)再(zai)審(shen)案(an)件(jian),隻(zhi)適(shi)用(yong)於(yu)人(ren)民(min)法(fa)院(yuan)正(zheng)在(zai)審(shen)理(li)的(de)一(yi)審(shen)或(huo)者(zhe)二(er)審(shen)案(an)件(jian)。這(zhe)是(shi)一(yi)個(ge)基(ji)本(ben)的(de)原(yuan)則(ze)。那(na)麼(me)這(zhe)個(ge)通(tong)知(zhi)裏(li)麵(mian)第(di)一(yi)條(tiao)第(di)二(er)款(kuan)是(shi)跟(gen)所(suo)有(you)的(de)司(si)法(fa)解(jie)釋(shi)的(de)適(shi)用(yong)原(yuan)則(ze)是(shi)一(yi)致(zhi)的(de)。
這zhe個ge通tong知zhi第di一yi條tiao,涉she及ji到dao一yi個ge實shi用yong條tiao例li的de糾jiu紛fen案an的de問wen題ti,後hou麵mian講jiang的de一yi個ge實shi際ji上shang是shi在zai糾jiu紛fen上shang的de問wen題ti。醫yi療liao糾jiu紛fen是shi一yi個ge籠long統tong的de概gai念nian。那na麼me我wo們men說shuo的de醫yi療liao糾jiu紛fen,雖sui然ran從cong法fa律lv上shang目mu前qian的de法fa律lv沒mei有you對dui醫yi療liao糾jiu紛fen作zuo為wei一yi個ge立li法fa定ding義yi來lai講jiang,但dan是shi可ke以yi準zhun確que地di說shuo,醫yi療liao糾jiu紛fen是shi一yi個ge非fei常chang大da的de概gai念nian。醫yi療liao糾jiu紛fen裏li麵mian,醫yi療liao賠pei償chang糾jiu紛fen,隻zhi是shi醫yi療liao糾jiu紛fen當dang中zhong的de一yi個ge小xiao部bu分fen,那na麼me另ling外wai引yin起qi醫yi療liao賠pei償chang糾jiu紛fen的de原yuan因yin,非fei常chang之zhi多duo。隻zhi要yao是shi患huan者zhe或huo者zhe是shi就jiu醫yi到dao醫yi療liao機ji構gou就jiu醫yi,無wu論lun是shi按an照zhao哪na一yi種zhong性xing質zhi定ding性xing,總zong之zhi會hui可ke能neng產chan生sheng各ge種zhong各ge樣yang的de糾jiu紛fen。我wo們men認ren為wei,醫yi療liao事shi故gu,隻zhi是shi產chan生sheng醫yi療liao賠pei償chang糾jiu紛fen當dang中zhong的de一yi種zhong原yuan因yin,當dang然ran這zhe種zhong原yuan因yin可ke能neng是shi最zui主zhu要yao的de原yuan因yin。
kaolvdaoyiliaoshiguchulitiaoliduiyiliaoshiguzuochuleyigelifadedingyi,yejiushishuo,womensuochengdeyiliaoshigujuyoutedingdefadingyiyi,suoyiwomenrenwei,yiliaoshiguyinqideyiliaojiufen,zhinengshiquanbuyiliaopeichangjiufenhuozheshiquanbuyiliaojiufendangzhongdeyibufen。namejiyuzhezhonglijie,womenrenwei,yiliaojiufenfenliangbufen。yibufenshiyouyiliaoshiguyinqideyiliaojiufen。lingyibufenshiyinyiliaoshiguyuwaijiedeyuanyin,yinqidepeichangjiufen。nameduishenmeshiyiliaoshiguyiwaideyuanyinyinqideqitayiliaopeichangjiufen。suiranshuo,butongrenyoubutongdelijie,jiuwogerendelijie,worenwei,zhegeyiliangshiguyiwaideyuanyin,yinqidepeichangjiufen,zhuyaoshixiamianzhemejizhongqingkuang,diyizhongqingkuangjiushishuo,yizhongyiliaoguyixingwei,womendajiadouzhidao,womenyiliaoshigutiaolidiertiaojiangdeshi,yiliaoshigushizhiyiliaoweishengjigoujiqigongzuorenyuanweifanweigui,guoshizaochenghuanzhederenshensunhaipeichang,guoshizaochenghuanzhederenshensunhaideshigu。namecongzhegedingyigenzimiankeyikanchulai,zhelimianduiyuyiliaojigouhuozheshiqiyiwurenyuantaguyidexingwei,guyizaochenghuanzherenshensunhaideqingkuangshipaichuzaiyiliaoshiguzhiwai。nashenmeshiyiliaoguyine?yiliaoguyishizhiyiliaojigouhuozheshiyiwurenyuan,worenweiyiwurenyuanzaishixingzhegeguochengdangzhongdeshiwuyingdangshiweiyiliaojigoudeshiwu,huozheshuoyiliaogongzuorenyuanzailvxingzhizedangzhongdezeren,yingdangyouyiliaojigoulaichengdan。nameyiliaoguyijiushiyiliaofangguyiweifanfalvdeyiwu,huozheshizhizeshangdeyiwu,geihuanzhezaochengsunhaihouguodeyiliaoxingwei。zhezhongsunhaidebiaomianxingshizhuyaoshiqinhaihuanzhehuozheshiqitajiuyizhedeshengmingquanli,jiankangquanli。yiliaoguyi,womengangcaijiangguole,anbaokuoyiliaojigoudeguyi,huozheshiyiwugongzuorenyuanguyi,yebaokuoyishiheqitarenyuandeguyi。nameyishili,yiwugongzuorenyuanlvxingzhizedeguyi,nameyingdangrenwei,huozheshiweiyiliaojigoudeguyi,dangranyingdangyouyiliaojigoulaichengdanzeren。nameyiliaojigoudeguyi,tadebiaoxianxingshiyouhenduo。
woduiyiliaobenshendezhegexingweilejieshifeichangyouxian,namewoxiang,yinggaishibaohanle,tazhishishengchanpeizhiweijingguojiajianyandeyaowu,yinweiyouhenduoyiyuandouhuiyouyixiezifeideyaowu,anzhaoyaopinguanlifadeguiding,zhexiedoushiyaowudeshengchanhepeizhiyingdangjingguoguojiazhuanmenjianyanpizhun。zhezhongqingkuang,tageihuanzhezaochengdeyaowurenxingdesunhai,wolijiewei,zhebunengrenweishiyizhongguoshixingwei。zheshiyizhongyinweiyaopinyinqide。lingwaiyizhongbiaoxianxingshishigoumaibuhegede,huozheshitaotaideyiliaoqixie,zaochenghuanzhewuzhenhuozheqitayinyuanxingjibing。zaiwokandaodeyouyixieyiyuanjiushimaitaotaide,huozheguoshidezhezhongyiliaoqixie。
haiyouyizhongbiaoxianxingshi,baokuoshanzicaijihuozheshiyongweijingjianyandexueyejixueyezhipin,shiyongguoqiyaopinhuozheshijinzhishiyongdeyaowu,zheshiyizhongbiaoxianxingshi。chulezhexiejutidelizizhiwai,kenenghaihuiyouqitade。woshoujideziliaoyouxian,suoyiwozhinengdazhigeidajiajieshaozhexieshili。youjigefeichangjiandandelizi,yangqishiyongdewenti,dajiakenengdouhuizhidao,zaiyiyuanlishiyongdeyangyinggaishiyiyongyang,zaiwosuokandaodeziliaodangzhong,youxieren,yonggongyeyanglaidaitiyiyongyang,zuoweiyigezhuanyejigou,zhuanyederenshi,taduiyiyongyanghegongyeyangyinggaishiyoufeichangqingchudelejie。ruguotayonggongyeyanglaidaitiyiyongyangdeshihou,zhizhishaoworenwei,hennanrendingzhezhongxingweishiyizhongguoshixingwei,yinweiwomenjiangdeguoshizhideshizhuguanshangdeguoshi,zuoweiyizhongzhuanyerenshi,ruguoshiyongzhuyaoshiyongyugongyeyongtudeyangdaitiyongyangdehua,namezhegehuanzhechuxianwenti,jiuhennanrenweibushiyizhongguyixingwei。youxieyiyuanhaimaileyixietaotaidejiqi,zhegeyerenweishiyizhongguyixingwei。wozengjinghaikandaozhemeyigeanjian。youxieyiwurenyuanweilebendanwei,huozheshigerendeliyi,guyijialeyixiebenlaijiuyizhehegedezhengchangdejianyanbaogaogaiweiyichang,ranhoujianghuanzheshouliuzhuyuan,zhezhongqingkuangnihennanrenweitashiyizhongguoshidexingwei。zheshiyiliaoguyi,zheshizuoweiyiliaojigoudeguyi。zuoweiyiwugongzuorenyuandeguyi,haiyouyixieqitadebiaoxianxingshi。yinweiwomenjiang,yiliaojiufendengyushiyongdadegainian,namebaokuoduihuanzheshenti,yebaokuoduihuanzheqitadequanli。qishiwomenzaiqianjinian,dajiadouhuizhidaode,beijingzengjingfashengyijianshiqing,yigeyankeyishengweilegeiyigehuanzhezhibing,shanzicongyigehuanzheshitishangbanageshuangyanjiaomoquxialai,yongzailingwaiyigehuanzheshenshang,zhegejiuyinqileminshijiufen,congminshiquanlidejiaodukan,tongyangshiyizhongqinquanxingwei,tongyangyinqiyiliaojiufen,zhezhongyiliaojiufen,suiranshuocongzhuguanshang,kenengshiweilegeihuanzhetigongjiaomo,danshicongkeguanshangqueshizaochengleqinhaiquanlidexingwei,zhezhongxingweibuyingdangrenweishiyizhongguoshixingwei。
這(zhe)是(shi)一(yi)種(zhong)醫(yi)療(liao)事(shi)故(gu)以(yi)外(wai)的(de)故(gu)意(yi)問(wen)題(ti)。第(di)二(er)個(ge)問(wen)題(ti),我(wo)覺(jiao)得(de)是(shi)非(fei)法(fa)行(xing)醫(yi)的(de)問(wen)題(ti),無(wu)論(lun)是(shi)按(an)照(zhao)我(wo)們(men)醫(yi)療(liao)機(ji)構(gou)管(guan)理(li)條(tiao)例(li),還(hai)是(shi)按(an)照(zhao)職(zhi)業(ye)醫(yi)師(shi)法(fa),還(hai)是(shi)其(qi)他(ta)有(you)關(guan)法(fa)律(lv)的(de)規(gui)定(ding),從(cong)事(shi)醫(yi)療(liao)活(huo)動(dong)應(ying)當(dang)經(jing)過(guo)國(guo)家(jia)有(you)關(guan)部(bu)門(men)的(de)許(xu)可(ke),取(qu)得(de)相(xiang)關(guan)資(zi)格(ge),或(huo)者(zhe)是(shi)指(zhi)導(dao)的(de)行(xing)為(wei)。如(ru)果(guo)沒(mei)有(you)取(qu)得(de)醫(yi)療(liao)許(xu)可(ke)機(ji)構(gou)或(huo)者(zhe)其(qi)他(ta)人(ren)員(yuan),給(gei)其(qi)他(ta)人(ren)行(xing)醫(yi)造(zao)成(cheng)人(ren)身(shen)損(sun)害(hai)的(de)話(hua),如(ru)果(guo)是(shi)情(qing)節(jie)很(hen)重(zhong)判(pan)處(chu)刑(xing)法(fa)的(de)非(fei)法(fa)行(xing)醫(yi)罪(zui),如(ru)果(guo)是(shi)行(xing)為(wei)比(bi)較(jiao)輕(qing),就(jiu)是(shi)民(min)事(shi)的(de)人(ren)身(shen)損(sun)害(hai)賠(pei)償(chang)。這(zhe)是(shi)一(yi)種(zhong)非(fei)法(fa)行(xing)醫(yi)。
disanzhongqingkuang,yiliaojigouhuoyiwurenyuanzaiyiliaohuodongdangzhongqinfanhuanzhehuozhejiuyizheqitadequanli。jiushiqinhaitadeyinsiquan,yinweihenduoqingkuangxia,huanzheduitazijisuodedemouyifangmianjibing,buxiwangbierenlejie,yishengshilejiede,ruguoyishengjiangzijisuozhangwodezhexieqingkuangxiangwaijiexieludehua,jiukenenggouchengqinhaiyinsiquandeqingkuang,dangranduihuanzhezaochengshentishanghuozheshengmingshang,huozhejiankangshangdesunhai,queshigouchengyizhongqinquan,suoyiworenwei,yeyingdangshiyiliaoshiguyiwaideyuanyin。zaiwomenyiliaoshiguchulitiaoli,huozheshiqitadefalvguiding,jiuyizhehuozhehuanzhezaiyiliaohuodongdangzhongyouqitadequanli。chakanbingli,huozheshibingliweijingxuke,yiyuanbunenggouduitarenjinxingchakan。zhezhonghuiyinqijiufen,danzhezhongjiufen,tongyang,worenweibushiyizhongyiliaoshigu。nameyouyiliaoshiguyiwaideyuanyin,daozhizhegeanzi,womenmuqianhaimeiyouyigewanquandechuli、分類、歸納。我隻能是舉一些例子。
shuodaozhegewenti,youyigefeichangguanjiandewenti,jiushishuo,zaichuliyiliaojiufendangzhong,ruheshiyongzhexietiaoli,huozheshicanzhaozhexietiaoli。yushiyongminfatongzedeguanxi,guoquzaiyiliaoshiguchulibanfadangzhong,zhegebanfasuiranjiuyiliaoshiguchulidejibenwenti,huozheshiyiliaopeichangwentizuoleyixiejibenguiding,huozheshiyuanzexingguiding。danshiyouyuzhegebanfa,youguanyiliaojiandingdetongguoxingwenti,yiliaopeichangbiaozhunguodidengdengwenti,shijiandangzhong,zhegebanfadaohoulaishiyuelaiyuebubeihenhaodezhixing。huozheshuo,zaiguanchezhixingyiliaoshiguchulibanfadeshihouchanshenglefeichangfeichangduodehuanzhedejiufen。namezaizheyangdeqingkuangxia,congwolejiedeqingkuangkan,henduorenminfayuanzaisifashijiandangzhong,tongchangshigenjudangshirendeqisujuedingzhegefalvdeshiyong。yejiushishuo,ruguodangshirenanzhaoyiliaoshigubanfazouyiliaoshiguxingzhengjianding,zouzhetiaotujingdehua,nametamentongchangshianzhaobanfadeguidinglaichuli,ruguodangshirenyirenshensunhaipeichangweiyou,tiqiminshisusongdehua,namefayuantongchangshianzhaominfatongzedeguidinglaichuli。bukaolvzhegebanfadeguiding。nameduizhezhongzuofa,zanchengrenhefanduirendouyouliyou。zanchengrenrenwei,anzhaominfatongzedeguidingyousunhaijiuyinggaiyoujiuji,erqieminshitongzeguiding,fanshiyinweizijideguoshi、過guo錯cuo,給gei他ta人ren造zao成cheng損sun害hai都dou應ying當dang承cheng擔dan賠pei償chang原yuan則ze,反fan對dui的de人ren認ren為wei一yi方fang麵mian作zuo為wei國guo務wu院yuan的de醫yi療liao事shi故gu處chu理li辦ban法fa這zhe樣yang的de行xing政zheng法fa,就jiu專zhuan門men的de醫yi療liao糾jiu紛fen問wen題ti或huo者zhe是shi醫yi療liao事shi故gu處chu理li問wen題ti已yi經jing做zuo了le規gui定ding。換huan句ju話hua說shuo,他ta認ren為wei,醫yi療liao事shi故gu處chu理li辦ban法fa所suo規gui定ding的de這zhe種zhong處chu理li方fang法fa是shi對dui民min法fa通tong則ze的de一yi種zhong變bian通tong的de規gui定ding。
由you這zhe兩liang種zhong不bu同tong的de方fang法fa,不bu同tong的de法fa律lv對dui案an件jian的de處chu理li有you很hen重zhong大da的de影ying響xiang,從cong患huan者zhe方fang來lai講jiang,通tong常chang是shi按an照zhao民min法fa通tong則ze的de規gui定ding來lai處chu理li,而er醫yi療liao方fang通tong常chang要yao求qiu按an照zhao醫yi療liao事shi故gu辦ban法fa來lai處chu理li。這zhe是shi一yi種zhong情qing況kuang。另ling外wai在zai司si法fa實shi踐jian當dang中zhong,還hai有you一yi種zhong情qing況kuang,就jiu是shi說shuo,如ru果guo是shi按an照zhao醫yi療liao事shi故gu處chu理li辦ban法fa鑒jian定ding某mou一yi項xiang醫yi療liao行xing為wei,或huo者zhe是shi某mou一yi個ge醫yi療liao行xing為wei引yin起qi的de後hou果guo,不bu構gou成cheng醫yi療liao事shi故gu,那na麼me患huan者zhe方fang或huo者zhe是shi法fa院yuan主zhu動dong地di進jin行xing司si法fa鑒jian定ding,來lai判pan斷duan這zhe個ge醫yi療liao機ji構gou的de行xing為wei,或huo者zhe是shi活huo動dong。與yu這zhe個ge患huan者zhe的de損sun害hai後hou者zhe之zhi間jian是shi保bao存cun著zhe一yi種zhong醫yi療liao過guo錯cuo。也ye就jiu是shi說shuo,它ta跟gen醫yi療liao機ji構gou在zai主zhu觀guan上shang是shi否fou有you過guo錯cuo,如ru果guo是shi過guo錯cuo,隻zhi要yao這zhe個ge鑒jian定ding認ren為wei,醫yi療liao機ji構gou的de行xing為wei對dui患huan者zhe的de損sun害hai,在zai主zhu觀guan上shang存cun在zai過guo錯cuo,客ke觀guan上shang存cun在zai因yin果guo關guan係xi,那na麼me法fa院yuan通tong常chang會hui在zai行xing政zheng途tu徑jing之zhi外wai,來lai判pan定ding醫yi療liao機ji構gou承cheng擔dan一yi定ding的de民min事shi責ze任ren。這zhe是shi過guo去qu的de做zuo法fa。
namewomenxianzaideyiliaoshigutiaoli,yuyiliaoshiguchulibanfaxiangbi,taqueshiyouhenduodejinbu,zhegebujinjinbiaoxianzaijiandingwentishang,biaoxianzaipeichangzerenshuedehuafenshang,danshigenjutongji,xianxingdeyixuehuimuqiancongqunianyihou,zuzhileshenqingjiandingdesuoyoudeanzidangzhong,nenggoutazhichiyiliaoshigudezhezhongjielun,dagaizhanquanbushenqingdesanfenzhiyizuoyou,yuguoquxiangbiyouhendadetigao。danshidabufendeshenqingdourenweidabufendezhezhongyiliaohuodong,youhuanzhetichuyiyi,dourenweishiyizhongyiliaoshigu。duiyubushiyiliaoshigudezhezhongyiliaoxingwei,shibushihaixuyaojinyibudejianding。tebieshisifahaixuyaotongguofayuandejigou,huozheshiyouguanyixuehuiyiwaideguocuojianding。wotingdaoleyixienianqingdefayuandezuofashizheyangde。youxiedifangrengranshiyanyongguoqudezuofa。chufeiyixuehuizuzhijianding,jiandingmouyigeyiliaoxingweiyinqidehouguo,chuyiliaoshiguzhiwai,ruguozaijiandingbushidehua,zhiyaohuanzhebufu,takenengrengranyouquanlijinxingsuoweideguocuojianding,zhiyaozhegeyiliaojigouyouguocuo,fayuanjiupanjueyiliaojigouchengdanyidingdezeren。ruguozhiyoufayijianding,rengranrenwei,yiliaojigouduizhegehuanzhederenshensunhaimeiyouzhegeguocuo,namejiupanjueyiliaojigoubucunzairenhezeren,bohuiyuangaodesusongqingqiu。dangranyeyoufayuangenjuyixuehuidejiandingsuozhichudeyiyiliaojigouzaimouxiefangmiancunzaiyidingdeshiwuweiyiju,tamenchengdanzeren。
這zhe是shi一yi個ge限xian製zhi的de做zuo法fa。那na麼me最zui後hou對dui這zhe個ge問wen題ti的de理li解jie,不bu僅jin僅jin是shi我wo個ge人ren理li解jie,我wo覺jiao得de,如ru果guo是shi醫yi學xue會hui組zu織zhi的de鑒jian定ding,就jiu是shi按an照zhao合he法fa權quan限xian,公gong正zheng地di走zou這zhe個ge鑒jian定ding,得de出chu來lai某mou一yi個ge醫yi療liao行xing為wei所suo造zao成cheng的de醫yi療liao後hou果guo不bu構gou成cheng醫yi療liao事shi故gu,我wo覺jiao得de這zhe樣yang的de情qing況kuang下xia,不bu應ying當dang再zai做zuo其qi他ta鑒jian定ding。按an照zhao醫yi療liao事shi故gu處chu理li條tiao例li的de程cheng序xu做zuo多duo層ceng鑒jian定ding之zhi外wai,初chu級ji鑒jian定ding,二er次ci鑒jian定ding,甚shen至zhi甚shen至zhi有you中zhong華hua醫yi學xue會hui鑒jian定ding,這zhe種zhong鑒jian定ding認ren為wei,某mou一yi個ge事shi故gu不bu構gou成cheng醫yi療liao事shi故gu的de話hua,醫yi療liao機ji構gou就jiu不bu應ying當dang承cheng擔dan這zhe種zhong民min事shi的de賠pei償chang責ze任ren。這zhe是shi我wo的de一yi個ge理li解jie。
對於這個問題的理解,就涉及到我們條例第49條,第二款規定的問題。因為這個醫療事故處理條例第49條(tiao),第(di)二(er)款(kuan)的(de)規(gui)定(ding),不(bu)屬(shu)於(yu)醫(yi)療(liao)事(shi)故(gu)的(de),醫(yi)療(liao)機(ji)構(gou)不(bu)承(cheng)擔(dan)賠(pei)償(chang)責(ze)任(ren)。應(ying)當(dang)說(shuo),這(zhe)個(ge)規(gui)定(ding)應(ying)該(gai)是(shi)一(yi)個(ge)比(bi)較(jiao)明(ming)確(que)的(de)規(gui)定(ding)。當(dang)然(ran)了(le),就(jiu)我(wo)所(suo)知(zhi),或(huo)者(zhe)說(shuo)昨(zuo)天(tian)我(wo)們(men)跟(gen)他(ta)們(men)兩(liang)位(wei)領(ling)導(dao)給(gei)你(ni)們(men)介(jie)紹(shao)了(le)一(yi)下(xia),這(zhe)個(ge)表(biao)述(shu)在(zai)原(yuan)來(lai)的(de)起(qi)草(cao)過(guo)程(cheng)當(dang)中(zhong),他(ta)們(men)的(de)表(biao)述(shu)是(shi)不(bu)完(wan)整(zheng),我(wo)的(de)印(yin)象(xiang)當(dang)中(zhong),不(bu)屬(shu)於(yu)醫(yi)療(liao)事(shi)故(gu),醫(yi)療(liao)機(ji)構(gou)不(bu)承(cheng)擔(dan)醫(yi)療(liao)事(shi)故(gu)的(de)賠(pei)償(chang)責(ze)任(ren),最(zui)終(zhong)在(zai)法(fa)律(lv)法(fa)規(gui)當(dang)中(zhong),把(ba)這(zhe)個(ge)不(bu)承(cheng)擔(dan)醫(yi)療(liao)事(shi)故(gu)賠(pei)償(chang)責(ze)任(ren)已(yi)經(jing)改(gai)為(wei)不(bu)承(cheng)擔(dan)賠(pei)償(chang)責(ze)任(ren)。那(na)我(wo)覺(jiao)得(de),我(wo)們(men)最(zui)高(gao)人(ren)民(min)法(fa)院(yuan)在(zai)這(zhe)個(ge)通(tong)知(zhi)當(dang)中(zhong),所(suo)指(zhi)的(de)醫(yi)療(liao)事(shi)故(gu)的(de)原(yuan)因(yin),並(bing)不(bu)是(shi)指(zhi)的(de)是(shi),如(ru)果(guo)聽(ting)了(le)醫(yi)學(xue)會(hui)的(de)鑒(jian)定(ding),某(mou)一(yi)個(ge)醫(yi)療(liao)行(xing)為(wei)所(suo)造(zao)成(cheng)的(de)後(hou)果(guo)不(bu)構(gou)成(cheng)醫(yi)療(liao)事(shi)故(gu),還(hai)是(shi)要(yao)做(zuo)一(yi)個(ge)鑒(jian)定(ding),鑒(jian)定(ding)這(zhe)個(ge)醫(yi)療(liao)機(ji)構(gou)的(de)醫(yi)療(liao)活(huo)動(dong),對(dui)患(huan)者(zhe)的(de)損(sun)害(hai)後(hou)果(guo)之(zhi)間(jian)是(shi)否(fou)存(cun)在(zai)著(zhe)後(hou)果(guo)。如(ru)果(guo)有(you)過(guo)錯(cuo)的(de)話(hua),那(na)麼(me)他(ta)要(yao)承(cheng)擔(dan)一(yi)定(ding)的(de)責(ze)任(ren),我(wo)覺(jiao)得(de)不(bu)是(shi)這(zhe)麼(me)理(li)解(jie)。我(wo)的(de)這(zhe)種(zhong)看(kan)法(fa),除(chu)了(le)醫(yi)療(liao)事(shi)故(gu)處(chu)理(li)條(tiao)例(li),第(di)二(er)款(kuan)的(de)規(gui)定(ding)之(zhi)外(wai),從(cong)民(min)事(shi)侵(qin)權(quan)法(fa)裏(li)麵(mian)看(kan),有(you)一(yi)種(zhong)人(ren)認(ren)為(wei),因(yin)為(wei)我(wo)們(men)現(xian)在(zai)的(de)醫(yi)療(liao)事(shi)故(gu)處(chu)理(li)條(tiao)例(li),把(ba)醫(yi)療(liao)事(shi)故(gu)分(fen)為(wei)四(si)個(ge)等(deng)級(ji),其(qi)中(zhong)第(di)四(si)級(ji)指(zhi)的(de)是(shi)醫(yi)療(liao)活(huo)動(dong)對(dui)於(yu)患(huan)者(zhe)的(de)人(ren)身(shen)損(sun)害(hai),造(zao)成(cheng)其(qi)他(ta)明(ming)顯(xian)的(de)損(sun)害(hai)後(hou)果(guo)。換(huan)句(ju)話(hua)說(shuo),如(ru)果(guo)是(shi)造(zao)成(cheng)不(bu)明(ming)顯(xian)的(de)損(sun)害(hai)後(hou)果(guo),那(na)麼(me)這(zhe)個(ge)醫(yi)療(liao)機(ji)構(gou)對(dui)患(huan)者(zhe)的(de)損(sun)害(hai)不(bu)應(ying)當(dang)認(ren)為(wei)是(shi)醫(yi)療(liao)事(shi)故(gu),也(ye)就(jiu)是(shi)說(shuo),它(ta)不(bu)應(ying)當(dang)承(cheng)擔(dan)責(ze)任(ren)。
zhezhongsunhai,zhezhongbumingxiandesunhai,tamenrenweishibujuyoubuchangxing,bujuyoukepeichangxing。duiyuyiliaoshigujiandingyihou,jiandingruguomeiyougouchengyigeyiliaoshigudejielunyihou,shibushihaiyaozuofayijianding,huozheshiyaobuyaochengdanzerenwenti。worenwei,sifazhegewenti,womenduiquanliguidingbugouchengyiliaoshigu,yiliaojigoujiubuchengdanzhegepeichangzeren。qianmianwojiangguo,ruguoshuozaiyiliaoshiguyiwaideyixieyuanyin,yinqidepeichangjiufen,nameyiliaojigouyaochengdanzeren,namezhedangzhong,zenmeyigequfen,namewojibenmuqian,yigebuchengshudexiangfajiushishuo,huanzherenwei,yiliaojigouyaochengdanzerende,namebingbushijiandandishuo,zhiyaoshiyiyuanhehuanzhezhijianfashengjiufende,nameyiyuanjiuyingdangzhengming,tadexingweiyuhuanzhedesunhaihouguozhijianshifoucunzaiyinguoguanxi。namewojiaode,zaiyixiegerendeqingkuangxia,ruguoshihuanzherenwei,suiranmouyixiangyiliaoxingwei,zaochengsunhaihouguode,bugouchengyiliaoshigu,danshizaiyixietedingqingkuangxia,wojiaodeyinggaishiyouhuanzhelaizhengming。tadequanliqishishoudaolesunhai。yejiushishuo,womenqianmianjudelizi,ruguoshiyinweiyiliaojigouqinfanhuanzheyinsiquandeqingkuangxia,nametayehuiyinqizhezhongyiliaojiufen。danshizhezhongjiufendexingzhiyuzhezhongyiliaoshiguyinqidesunhaipeichangxingzhi,yinggaishiyoubijiaozhongdadequbie。namezaiqinhaiyinsiquandeqingkuangxiasuozaochengdezhezhongsuoyaoqiudezhezhongjuzhengzerendefendan,huozheshilongtongdishiyong,huozheshiyingdangshiyong,zhezhongdianxingdeyiliaoshigupeichangdeyibandeyiliaojiufendejuzhengzeren。
我wo要yao說shuo明ming的de是shi我wo們men仍reng然ran有you人ren認ren為wei,不bu構gou成cheng醫yi療liao事shi故gu,如ru果guo是shi這zhe種zhong醫yi療liao機ji構gou的de醫yi療liao活huo動dong與yu患huan者zhe的de損sun害hai賠pei償chang之zhi間jian隻zhi要yao存cun在zai著zhe有you過guo錯cuo,那na麼me醫yi療liao機ji構gou可ke以yi應ying當dang承cheng擔dan賠pei償chang責ze任ren。也ye有you人ren這zhe麼me理li解jie。這zhe是shi一yi個ge大da家jia最zui關guan心xin的de問wen題ti。這zhe個ge問wen題ti可ke能neng還hai需xu要yao具ju體ti探tan討tao。我wo覺jiao得de,我wo們men最zui高gao人ren民min法fa院yuan已yi經jing明ming確que規gui定ding,人ren民min法fa院yuan在zai審shen理li醫yi療liao配pei賠pei償chang糾jiu紛fen當dang中zhong,參can照zhao條tiao例li的de規gui定ding來lai處chu理li的de話hua,那na應ying當dang對dui這zhe個ge條tiao例li有you完wan整zheng的de正zheng確que的de,或huo者zhe說shuo程cheng序xu的de理li解jie。那na麼me這zhe涉she及ji到dao這zhe個ge通tong知zhi有you關guan係xi的de一yi個ge最zui主zhu要yao的de問wen題ti。
這個承擔責任是否有關係的另外一個小問題,就是我這個提綱裏麵提到幾個小問題,就是說,關於醫療機構免責的問題。我們條例第33tiao,duibugouchengyiliaoshigudeqingkuang,zuoleminshidejianding,guidingyouliuzhongyiliaohuodongdaozhidehouguobushuyuyiliaoshigu。namezheyitiaodeguiding,shijishangzheshiwomenfayuanhuozheshuoduiqitaderenpanduan,zhegeyiliaojigouyaobuyaochengdanzerenyouyigefeichangzhongyaodeyingxiang。nawozhelijiuwogerendelijie,tanyidianfeichangcuqiandekanfa。zhegegentongzhiyouguan,danshibushiwanquanshiyouguandewenti。
第33條(tiao)規(gui)定(ding)六(liu)種(zhong)情(qing)況(kuang),一(yi)種(zhong)情(qing)況(kuang)是(shi)在(zai)緊(jin)急(ji)情(qing)況(kuang)下(xia)搶(qiang)救(jiu)垂(chui)危(wei)患(huan)者(zhe)生(sheng)命(ming)而(er)采(cai)取(qu)緊(jin)急(ji)醫(yi)學(xue)措(cuo)施(shi)造(zao)成(cheng)不(bu)良(liang)後(hou)果(guo)的(de)。第(di)二(er)在(zai)醫(yi)療(liao)活(huo)動(dong)當(dang)中(zhong),由(you)於(yu)患(huan)者(zhe)精(jing)神(shen)異(yi)常(chang),病(bing)情(qing)異(yi)常(chang)或(huo)者(zhe)患(huan)者(zhe)體(ti)質(zhi)特(te)殊(shu)而(er)發(fa)生(sheng)醫(yi)療(liao)意(yi)外(wai)。三(san),在(zai)現(xian)有(you)醫(yi)學(xue)科(ke)學(xue)技(ji)術(shu)條(tiao)件(jian)下(xia),發(fa)生(sheng)無(wu)法(fa)預(yu)測(ce),或(huo)者(zhe)不(bu)能(neng)防(fang)範(fan)的(de)不(bu)良(liang)後(hou)果(guo)的(de)。四(si),無(wu)過(guo)錯(cuo)過(guo)錯(cuo)責(ze)任(ren)造(zao)成(cheng)不(bu)良(liang)後(hou)果(guo)。五(wu),因(yin)患(huan)方(fang)原(yuan)因(yin)延(yan)誤(wu)診(zhen)療(liao)導(dao)致(zhi)不(bu)良(liang)後(hou)果(guo)的(de)。六(liu),因(yin)不(bu)可(ke)抗(kang)拒(ju)造(zao)成(cheng)不(bu)良(liang)後(hou)果(guo)的(de)。我(wo)們(men)對(dui)這(zhe)一(yi)條(tiao)的(de)理(li)解(jie),可(ke)能(neng)不(bu)能(neng)僅(jin)僅(jin)是(shi)從(cong)這(zhe)個(ge)條(tiao)例(li)的(de)字(zi)麵(mian)上(shang)去(qu)機(ji)械(xie)地(di)理(li)解(jie)。那(na)麼(me)對(dui)這(zhe)個(ge)條(tiao)例(li)的(de)這(zhe)六(liu)項(xiang)的(de)理(li)解(jie),應(ying)該(gai)說(shuo)是(shi)一(yi)個(ge)比(bi)較(jiao)全(quan)麵(mian)的(de)理(li)解(jie)模(mo)式(shi)。我(wo)們(men)這(zhe)裏(li)麵(mian)規(gui)定(ding),在(zai)現(xian)有(you)醫(yi)學(xue)科(ke)學(xue)技(ji)術(shu)條(tiao)件(jian)下(xia)發(fa)生(sheng)無(wu)法(fa)預(yu)料(liao),或(huo)者(zhe)不(bu)能(neng)防(fang)範(fan)的(de)不(bu)良(liang)後(hou)果(guo)。我(wo)覺(jiao)得(de)法(fa)院(yuan)如(ru)果(guo)是(shi)在(zai)一(yi)個(ge)判(pan)斷(duan)具(ju)體(ti)的(de)案(an)例(li)的(de)時(shi)候(hou),如(ru)果(guo)是(shi)僅(jin)僅(jin)是(shi)從(cong)字(zi)麵(mian)上(shang)理(li)解(jie)的(de)話(hua),那(na)麼(me)對(dui)醫(yi)療(liao)機(ji)構(gou)可(ke)能(neng)造(zao)成(cheng)非(fei)常(chang)不(bu)公(gong)平(ping)的(de)情(qing)況(kuang)。因(yin)為(wei)現(xian)有(you)的(de)醫(yi)學(xue)科(ke)學(xue)技(ji)術(shu),這(zhe)個(ge)條(tiao)例(li)裏(li)麵(mian)沒(mei)有(you)進(jin)行(xing)。實(shi)際(ji)上(shang)我(wo)們(men)的(de)醫(yi)院(yuan)都(dou)是(shi)醫(yi)療(liao)機(ji)構(gou)或(huo)者(zhe)是(shi)醫(yi)務(wu)工(gong)作(zuo)者(zhe)對(dui)現(xian)有(you)醫(yi)學(xue)科(ke)學(xue)技(ji)術(shu)的(de)掌(zhang)握(wo)是(shi)有(you)專(zhuan)業(ye)性(xing)的(de),有(you)區(qu)域(yu)限(xian)製(zhi)。不(bu)同(tong)專(zhuan)業(ye)的(de)人(ren),不(bu)同(tong)地(di)方(fang)的(de)人(ren)掌(zhang)握(wo)是(shi)不(bu)一(yi)樣(yang)的(de)。舉(ju)一(yi)個(ge)簡(jian)單(dan)的(de)例(li)子(zi),一(yi)個(ge)鄉(xiang)村(cun)的(de)衛(wei)生(sheng)所(suo)或(huo)者(zhe)是(shi)衛(wei)生(sheng)院(yuan),或(huo)者(zhe)其(qi)他(ta)醫(yi)生(sheng),他(ta)所(suo)掌(zhang)握(wo)的(de)醫(yi)學(xue)科(ke)學(xue)技(ji)術(shu)和(he)我(wo)們(men)北(bei)京(jing)市(shi)或(huo)者(zhe)上(shang)海(hai)市(shi)的(de)醫(yi)院(yuan)或(huo)者(zhe)醫(yi)生(sheng)所(suo)掌(zhang)握(wo)的(de)這(zhe)個(ge)醫(yi)學(xue)科(ke)學(xue)技(ji)術(shu)的(de)差(cha)別(bie)巨(ju)大(da)。同(tong)樣(yang),作(zuo)為(wei)中(zhong)國(guo)最(zui)好(hao)的(de)醫(yi)生(sheng)或(huo)者(zhe)醫(yi)院(yuan),所(suo)掌(zhang)握(wo)的(de)醫(yi)學(xue)科(ke)學(xue)技(ji)術(shu),跟(gen)國(guo)外(wai)或(huo)者(zhe)國(guo)際(ji)上(shang)頂(ding)點(dian)的(de)醫(yi)院(yuan)或(huo)者(zhe)醫(yi)務(wu)工(gong)作(zuo)者(zhe)所(suo)掌(zhang)握(wo)的(de)技(ji)術(shu)相(xiang)比(bi),也(ye)差(cha)別(bie)很(hen)大(da)。這(zhe)是(shi)一(yi)個(ge)方(fang)麵(mian)。就(jiu)是(shi)說(shuo),有(you)一(yi)個(ge)區(qu)域(yu)限(xian)製(zhi),還(hai)有(you)專(zhuan)業(ye)的(de)問(wen)題(ti)。作(zuo)為(wei)某(mou)一(yi)個(ge)領(ling)域(yu)裏(li)麵(mian)的(de)醫(yi)生(sheng)或(huo)者(zhe)是(shi)醫(yi)務(wu)工(gong)作(zuo)者(zhe),他(ta)不(bu)可(ke)能(neng)掌(zhang)握(wo)全(quan)部(bu)的(de)現(xian)行(xing),現(xian)有(you)的(de)醫(yi)學(xue)科(ke)學(xue)技(ji)術(shu),同(tong)時(shi),作(zuo)為(wei)一(yi)般(ban)常(chang)理(li),現(xian)有(you)醫(yi)學(xue)科(ke)學(xue)技(ji)術(shu)的(de)掌(zhang)握(wo),實(shi)際(ji)上(shang)分(fen)為(wei)知(zhi)識(shi)、jinengbutongdecengcilailijie。henduorenyexutazhishizhangwoxianyouyixuekexuejishudezhichi,danshitaweibiyoushishizhegexianyouyixuekexuejishudejineng。jishitazhangwozhezhongjineng,yeweibiyoushishixianyouyixuekeshulezhezhonggongju。namefayuanzaipanduanyishenghuozheyiwugongzuozheshifoubeimianzedeshihou,ruguolongtongdigujizhexiechabie,erlongtongdipanduanshuo,shiyongxianyoukexuejishudetiaojianxia,fashengwufayuliaohuozheshibunengfangfandehouguo,namezhehuichanshenghenduodewenti。yinweidangwomenxuyaoquzhuijiuhuozhetantaozaiyiliaoguochengdangzhong,huozheshiquanbuyiliaohuodongdangzhong,yishenghuozheshiyiyuanduimeiyigebinglishifouqiongjinlexianyoudeyixiekexuejishu。yejiushishuo,bunengmeiyouwanquanyingyongxianyoudeyixiekexuejishu,danshimeiyouzhihaobingjiuwanle。yishengdeyiliaojigoushibushiyaoyigaidichengdanzhechangyiliaoshigudezeren。
zaizheyangdeqingkuangxia,ruguoyizheyangdeyigelongtongdeguidinglaizuoweiyiyuandemianzedehua,shijishang,wulunshiduiyiliaojigou,haishiduihuanzhedoushimeiyouhaochudeshiqing。juyigefeichangjiandandelizi,zuoweiyiyuanweilemianzekenengjiuhuiranghuanzhejieshouwojinkenengcaiqudegezhonggeyangdejianzha,shijishang,zheyifangmian,taduiyiliaojigou,tamianzeyouhaochu,yekenengzaijingjiliyishangyouhaochu。danshitongshikenengranghuanzhezengjiayixiebubiyaodejingjifudan,jibianruci,youyumeiyigeyiliaojigou,huozheshimeiyigeyiwugongzuozhesuozhangwodeyixuejishubuyiyangdeqingkuangxia,nametajiuhuimianlinzhefeichangdadefengxian,zaizheyangdeqingkuangxia,yicizuoweitachengdanzerendebiaozhun,longtongdijiangqueshiyouhenduodongxi。suoyiwojiaodeduizhegelijie,queshiyinggaigenjujutideqingkuangpanduan。zhiyouzheyangdehua,cainengrangyiliaojigouhehuanzhegongpinghelidifendanyiliaojigouzaiyiliaohuodongdangzhongsuochendandefengxian,yijihuanzhezaijiuyiguochengdangzhongsuochengdandefengxian。zheshiyigelijie。
另外一個理解,我們第33條tiao裏li麵mian講jiang到dao了le,緊jin急ji情qing況kuang下xia,由you於yu患huan者zhe精jing神shen異yi常chang,這zhe實shi際ji上shang也ye是shi一yi個ge非fei常chang籠long統tong的de規gui定ding。這zhe樣yang的de規gui定ding,實shi際ji上shang對dui患huan者zhe是shi一yi個ge不bu利li的de規gui定ding。借jie此ci是shi醫yi療liao機ji構gou在zai搶qiang救jiu垂chui危wei患huan者zhe,或huo者zhe在zai患huan者zhe體ti質zhi特te殊shu,你ni不bu能neng籠long統tong地di說shuo,隻zhi要yao是shi有you這zhe兩liang種zhong情qing況kuang存cun在zai,醫yi療liao機ji構gou就jiu應ying該gai免mian責ze。我wo覺jiao得de,一yi個ge醫yi療liao機ji構gou是shi否fou免mian責ze應ying當dang看kan他ta是shi否fou盡jin到dao了le醫yi療liao機ji構gou應ying當dang注zhu意yi的de方fang麵mian,或huo者zhe通tong俗su地di說shuo,他ta是shi否fou盡jin了le謹jin慎shen小xiao心xin的de義yi務wu,如ru果guo一yi個ge醫yi療liao機ji構gou雖sui然ran是shi搶qiang救jiu垂chui危wei患huan者zhe,但dan是shi他ta一yi方fang麵mian沒mei有you醫yi療liao能neng力li,資zi格ge不bu夠gou,或huo者zhe是shi另ling一yi方fang麵mian,他ta沒mei有you遵zun守shou通tong常chang的de規gui範fan,那na麼me在zai這zhe樣yang的de情qing況kuang下xia,即ji使shi是shi搶qiang救jiu垂chui危wei患huan者zhe,而er采cai取qu緊jin急ji的de醫yi學xue措cuo施shi,造zao成cheng不bu良liang後hou果guo,我wo認ren為wei,仍reng然ran要yao承cheng擔dan責ze任ren。換huan句ju話hua說shuo,多duo數shu的de醫yi療liao機ji構gou,或huo者zhe是shi醫yi務wu工gong作zuo者zhe在zai同tong樣yang的de情qing況kuang下xia,他ta能neng夠gou采cai取qu合he理li的de措cuo施shi,能neng夠gou避bi免mian,雖sui然ran說shuo搶qiang救jiu垂chui危wei患huan者zhe,但dan是shi避bi免mian采cai取qu不bu利li的de後hou果guo,那na麼me其qi他ta的de人ren也ye應ying當dang遵zun守shou這zhe麼me一yi個ge規gui範fan。而er不bu能neng籠long統tong地di說shuo,隻zhi要yao是shi搶qiang救jiu垂chui危wei患huan者zhe的de生sheng命ming,而er采cai取qu緊jin急ji醫yi學xue措cuo施shi,造zao成cheng所suo有you的de不bu良liang後hou果guo。他ta都dou不bu承cheng擔dan責ze任ren。
zhegeyinggaishiduiyiyuandeyiliaorenyibandeyingxiang,tashifoujindaolejinshenzhuyideyiwu,shifouzunshouletongchangdeguifanlaipanduan。zheshiqiansanxiang,disi,wuguocuochuqiganran,zheyeshizhegetiaolimeiyoumingxianguilvde,zhegetiaolibingmeiyouduinaxieqingkuangshiguocuo,naxieqingkuangshiwuguocuo,ganranzaochengdehouguo。suoyiwuguocuoganranyehuiyinqizhengyi。wojiaode,guanyuzhegeganrandewenti,yinweiguoqushuxueyinqideganranyigan、丙肝、艾滋病等引起的糾紛也不少,目前這個仍然在爭論過程當中,仍然沒有得出一個最終的結論。
wojiaodexianzaiyiliaoshigutiaoli,longtongdishuo,zhiyaoshiyiliaojigou,yinweiwuguocuoshuxuezaochengyiliaohouguoshibushijiubuchengdanzeren。diwuxiangyinweihuanfangyuanyinyanwuzhenliaodaozhibulianghouguo,zheyeshilongtongguiding,wojiaodezaishijizhixingdangzhong,huozheshishiyongguochengdangzhong,yexuyaoyanjiu。yinweihenduoqingkuangxia,jiushishuo,yigefeichangjiandandelizi,anzhaowomendezhiyeyishi,huozheshiyiliaojigouguanlitiaoli,duiyixiechuiweihuanzhehuozheshichuiweibingren,yishishiyoujinjichuzhiyiwude。youdeyiyuanguidingnimeiyoujiaoqianwojiubucaiqucuoshi,zheyangdeqingkuangxia,ruguobachuiweihuanzhebunengjishichengdanyiliaofeiyong,guijieweihuanfangdeyuanyin,yanwuzhiliaodehua,yeshiyizhongweifadexingwei,erqieyeshibugongpingdeshiqing。
後(hou)麵(mian)就(jiu)是(shi)不(bu)可(ke)抗(kang)拒(ju)。因(yin)為(wei)不(bu)可(ke)抗(kang)拒(ju)造(zao)成(cheng)不(bu)良(liang)後(hou)果(guo),雖(sui)然(ran)說(shuo)不(bu)可(ke)抗(kang)拒(ju)通(tong)常(chang)是(shi)民(min)事(shi)活(huo)動(dong)當(dang)中(zhong)免(mian)責(ze)的(de)事(shi)由(you),但(dan)是(shi)大(da)家(jia)都(dou)會(hui)注(zhu)意(yi)到(dao),在(zai)我(wo)們(men)這(zhe)個(ge)合(he)同(tong)法(fa)和(he)我(wo)們(men)的(de)民(min)法(fa)通(tong)則(ze)規(gui)定(ding),是(shi)有(you)差(cha)別(bie)的(de)。按(an)照(zhao)民(min)法(fa)通(tong)則(ze)的(de)規(gui)定(ding)。凡(fan)是(shi)因(yin)為(wei)不(bu)可(ke)抗(kang)拒(ju)引(yin)起(qi)的(de)損(sun)害(hai),通(tong)常(chang)是(shi)不(bu)承(cheng)擔(dan)責(ze)任(ren)。我(wo)們(men)的(de)法(fa)律(lv)規(gui)定(ding),因(yin)為(wei)不(bu)可(ke)抗(kang)拒(ju),造(zao)成(cheng)不(bu)能(neng)履(lv)行(xing)的(de)是(shi)部(bu)分(fen)或(huo)者(zhe)是(shi)全(quan)部(bu)免(mian)除(chu)違(wei)約(yue)人(ren)的(de)責(ze)任(ren)。換(huan)句(ju)話(hua)說(shuo),這(zhe)個(ge)當(dang)然(ran)免(mian)除(chu)違(wei)約(yue)責(ze)任(ren)。也(ye)就(jiu)是(shi)說(shuo),從(cong)合(he)同(tong)法(fa)的(de)立(li)法(fa)精(jing)神(shen)看(kan),不(bu)可(ke)抗(kang)拒(ju)不(bu)能(neng)作(zuo)為(wei)完(wan)全(quan)免(mian)責(ze)的(de)事(shi)由(you)。我(wo)們(men)這(zhe)個(ge)條(tiao)例(li)裏(li)邊(bian),實(shi)際(ji)上(shang)將(jiang)不(bu)可(ke)抗(kang)拒(ju)作(zuo)為(wei)完(wan)全(quan)免(mian)責(ze)的(de)事(shi)由(you)。在(zai)醫(yi)學(xue)領(ling)域(yu)裏(li)麵(mian),也(ye)許(xu)就(jiu)比(bi)較(jiao)特(te)殊(shu)。這(zhe)是(shi)我(wo)對(dui)免(mian)責(ze)的(de)事(shi)項(xiang)。
woyaoqiangtiaoyidian,womenfayuanhuozhehuanzhe,huozheyiliaojigouzailijiezheyitiaodeshihou,kenengbunengguoyujuyuzimiandelijie。zheshigenzhegeyouguanxidelijie。haiyouyidian,tebieduiwomenfayuaneryan,zailijiezhegetiaoli,huozhezaichulishenpanyiliaojiufenguochengdangzhong。yinggaichongfendilijie,huozhelejieyiliaofangmianshiyigechongmangaofengxiandexingye。yifangmianwomenyaochongfendiyizhaofalvdeguiding,baohuhuanzhehuozhejiuzhizhedehefaquanyi,lingyifangmianyinweiyaokaolvdaogebiehuanzhedequantirendeliyideguanxi。zaizheyangdeqingkuangxia,caikenengshuozuochuyigebijiaogongping、合理的,做出社會公平合理的判決。
休息一刻鍾。
接著
王治平:
dajiafeichangguanxindeyigewenti,zenmelijietongzhisuotichulaideyiliaoshiguyiwaideyuanyin,womenzaizhegetongzhichutaiguochengdangzhong,zengjingzhengqiuguoguowuyuanfazhiban,zhengqiuguoweishengbudeyijian,tamenyoutongyidetifa。jiuyiliaoshiguyiwaideyuanyinshibushibaokuoyixuehuijiandingburenweishiyiliaoshigu,danshiyiliaojigoudehuodongyuhuanzhederenshensunhaihouguozhijiancunzaiguocuo,shibushibaokuozhezhongqingkuang。wogerenlijie,ruguobushiwosuoshuodenazhong,guyihuozhedengdengqingkuangzhiwai,buyingdangbaokuo。danshiwomenxianshidezuofa,baokuowomenbeijingshifayuan,beijingshilvshixiehuizengjingyouyigefaxuefangmianzhuanyoudehui,tagaosuwomenshi。yixiefayuanshijicaiyongdebushi,jingguoyixuehuijiandingbushiyiliaoshigu,ruguofayijiandingzhegeyiliaohuodongyurenshensunhaihouguozhijianyouyidingdeguocuo,tongchanghuipandingyiliaojigouchengdanzeren。zheshitamenshijidezuofa。wogerenlijie,worenweizhegeyinggaibushi。zheshiwogerendekanfa。gongdajiacankao。
我wo剛gang才cai講jiang的de這zhe裏li有you兩liang點dian,第di一yi點dian,是shi我wo們men以yi來lai事shi故gu條tiao例li明ming確que規gui定ding,醫yi療liao機ji構gou的de等deng級ji為wei四si級ji,其qi中zhong最zui後hou一yi級ji為wei醫yi療liao活huo動dong造zao成cheng患huan者zhe其qi他ta明ming顯xian的de人ren身shen損sun害hai後hou果guo。換huan句ju話hua說shuo,不bu明ming顯xian的de人ren身shen損sun害hai後hou果guo,醫yi療liao機ji構gou是shi不bu承cheng擔dan責ze任ren的de。這zhe是shi條tiao例li字zi麵mian的de理li解jie。另ling外wai一yi方fang麵mian,是shi第di49條tiao,第di二er款kuan規gui定ding,不bu構gou成cheng醫yi療liao事shi故gu的de醫yi療liao機ji構gou不bu承cheng擔dan醫yi療liao責ze任ren。這zhe是shi條tiao例li的de理li由you。另ling外wai從cong今jin天tian侵qin權quan法fa裏li麵mian講jiang。有you一yi種zhong觀guan點dian認ren為wei,有you一yi些xie損sun害hai後hou果guo,過guo輕qing不bu具ju有you補bu償chang性xing,或huo者zhe賠pei償chang性xing,這zhe是shi立li法fa的de依yi據ju,由you於yu我wo們men現xian在zai醫yi學xue會hui的de鑒jian定ding體ti製zhi的de緣yuan故gu,他ta實shi際ji鑒jian定ding過guo程cheng當dang中zhong,可ke能neng會hui與yu這zhe個ge條tiao例li的de製zhi定ding,國guo務wu院yuan或huo者zhe說shuo他ta起qi草cao這zhe個ge過guo程cheng,國guo務wu院yuan法fa製zhi辦ban的de真zhen實shi的de意yi圖tu未wei具ju有you完wan全quan一yi致zhi,造zao成cheng大da家jia反fan映ying非fei常chang強qiang烈lie的de時shi候hou,在zai很hen多duo的de情qing況kuang下xia,醫yi學xue會hui組zu織zhi鑒jian定ding,通tong常chang不bu認ren為wei,構gou成cheng醫yi療liao事shi故gu,但dan是shi患huan者zhe認ren為wei,它ta確que實shi受shou到dao損sun害hai。而er且qie從cong理li論lun上shang講jiang,按an照zhao民min法fa通tong則ze的de規gui定ding,凡fan是shi有you損sun害hai的de都dou應ying當dang要yao賠pei償chang。無wu論lun是shi實shi際ji的de做zuo法fa,還hai是shi理li論lun上shang的de依yi據ju,各ge有you道dao理li。我wo覺jiao得de,對dui這zhe個ge問wen題ti的de理li解jie,就jiu是shi從cong我wo們men這zhe個ge條tiao例li據ju我wo所suo知zhi,這zhe個ge條tiao例li起qi草cao多duo年nian,最zui早zao是shi立li法fa的de過guo失shi條tiao例li。在zai這zhe個ge條tiao例li的de起qi草cao過guo程cheng當dang中zhong,對dui這zhe個ge問wen題ti一yi直zhi爭zheng論lun不bu休xiu,一yi直zhi爭zheng論lun到dao現xian在zai。我wo想xiang最zui終zhong的de結jie果guo可ke能neng會hui立li法fa,或huo者zhe說shuo最zui高gao法fa院yuan在zai此ci就jiu這zhe個ge問wen題ti做zuo出chu更geng加jia具ju體ti明ming確que的de舉ju措cuo來lai。我wo前qian麵mian已yi經jing介jie紹shao過guo,因yin為wei這zhe個ge通tong知zhi是shi一yi個ge銜xian接jie性xing的de通tong知zhi。這zhe個ge司si法fa解jie釋shi,或huo許xu那na個ge時shi候hou對dui大da家jia所suo關guan注zhu的de問wen題ti給gei予yu一yi個ge比bi較jiao明ming確que的de規gui定ding。目mu前qian,可ke以yi這zhe樣yang理li解jie。我wo覺jiao得de這zhe是shi一yi個ge體ti製zhi的de問wen題ti。這zhe是shi非fei常chang大da的de問wen題ti。作zuo為wei我wo來lai講jiang,我wo具ju有you法fa官guan認ren證zheng,目mu前qian不bu在zai審shen判pan案an件jian,但dan是shi我wo同tong時shi也ye是shi患huan者zhe。作zuo為wei我wo來lai講jiang,也ye可ke能neng或huo者zhe說shuo,已yi經jing存cun在zai了le,醫yi療liao活huo動dong當dang中zhong,我wo構gou成cheng的de損sun害hai,比bi如ru我wo在zai好hao多duo年nian以yi前qian,因yin為wei我wo的de腳jiao一yi個ge指zhi頭tou長chang了le一yi個ge骨gu疣you,北bei京jing醫yi院yuan的de一yi個ge醫yi生sheng隨sui便bian看kan了le一yi眼yan,說shuo很hen簡jian單dan,叫jiao護hu士shi把ba支zhi架jia撥bo掉diao就jiu可ke以yi了le,那na個ge護hu士shi撥bo不bu出chu來lai,因yin為wei不bu是shi支zhi架jia的de問wen題ti,是shi跟gen骨gu頭tou連lian在zai一yi起qi。最zui後hou把ba支zhi架jia撥bo掉diao了le,但dan是shi骨gu疣you還hai在zai裏li麵mian,然ran後hou給gei我wo用yong了le大da量liang的de抗kang生sheng素su。我wo還hai是shi回hui去qu了le,後hou來lai也ye沒mei有you找zhao他ta。我wo從cong患huan者zhe的de身shen份fen,我wo非fei常chang關guan注zhu患huan者zhe的de利li益yi。從cong法fa官guan的de身shen份fen,我wo希xi望wang能neng夠gou追zhui求qiu一yi個ge公gong平ping合he理li的de解jie決jue。從cong醫yi療liao機ji構gou的de考kao慮lv,因yin為wei雖sui然ran我wo對dui醫yi療liao技ji術shu問wen題ti,並bing不bu了le解jie,但dan是shi我wo覺jiao得de,醫yi療liao機ji構gou是shi一yi個ge高gao風feng險xian,高gao技ji術shu的de行xing業ye。目mu前qian法fa院yuan在zai判pan斷duan這zhe個ge問wen題ti的de時shi候hou,確que實shi要yao處chu理li好hao和he患huan者zhe的de關guan係xi。這zhe是shi一yi個ge非fei常chang難nan把ba握wo的de事shi情qing。
在(zai)大(da)家(jia)休(xiu)息(xi)的(de)過(guo)程(cheng)當(dang)中(zhong),最(zui)關(guan)注(zhu)的(de)問(wen)題(ti),實(shi)踐(jian)上(shang)這(zhe)個(ge)過(guo)程(cheng),我(wo)個(ge)人(ren)的(de)理(li)解(jie)。大(da)家(jia)提(ti)了(le)很(hen)多(duo)問(wen)題(ti),其(qi)中(zhong)有(you)一(yi)個(ge)問(wen)題(ti)是(shi),認(ren)為(wei)比(bi)較(jiao)具(ju)有(you)過(guo)於(yu)具(ju)體(ti),第(di)一(yi)個(ge)問(wen)題(ti)是(shi),怎(zen)麼(me)理(li)解(jie)我(wo)們(men)這(zhe)個(ge)通(tong)知(zhi)當(dang)中(zhong),醫(yi)療(liao)事(shi)故(gu)以(yi)外(wai)的(de)原(yuan)因(yin),這(zhe)個(ge)我(wo)已(yi)經(jing)反(fan)複(fu)強(qiang)調(tiao)了(le)。下(xia)麵(mian)一(yi)個(ge)問(wen)題(ti)就(jiu)是(shi)說(shuo),患(huan)者(zhe)和(he)醫(yi)院(yuan)均(jun)不(bu)申(shen)請(qing)做(zuo)醫(yi)療(liao)事(shi)故(gu)鑒(jian)定(ding),患(huan)者(zhe)與(yu)醫(yi)院(yuan)有(you)無(wu)過(guo)錯(cuo)的(de)舉(ju)證(zheng),舉(ju)證(zheng)後(hou)的(de)後(hou)果(guo)由(you)誰(shui)來(lai)承(cheng)擔(dan)。
舉ju證zheng本ben身shen以yi及ji鑒jian定ding本ben身shen,我wo們men後hou麵mian就jiu講jiang,他ta們men幾ji位wei同tong誌zhi都dou會hui介jie紹shao。如ru果guo患huan者zhe或huo者zhe是shi原yuan告gao,與yu醫yi療liao損sun害hai賠pei償chang起qi訴su的de法fa院yuan,按an照zhao我wo們men的de證zheng據ju規gui定ding的de規gui定ding,那na麼me醫yi院yuan應ying當dang證zheng明ming他ta的de行xing為wei與yu患huan者zhe損sun害hai之zhi間jian沒mei有you因yin果guo關guan係xi。這zhe個ge舉ju證zheng的de方fang式shi,是shi不bu是shi必bi須xu都dou得de通tong過guo鑒jian定ding這zhe個ge程cheng序xu。這zhe是shi在zai條tiao例li的de起qi草cao當dang中zhong,包bao括kuo我wo們men的de通tong知zhi起qi草cao當dang中zhong,已yi經jing開kai始shi爭zheng論lun這zhe個ge問wen題ti。有you一yi種zhong情qing況kuang就jiu是shi說shuo,在zai很hen多duo案an件jian當dang中zhong,醫yi療liao機ji構gou它ta把ba它ta在zai整zheng個ge診zhen聊liao活huo動dong當dang中zhong,如ru實shi地di向xiang法fa院yuan提ti出chu來lai,之zhi間jian提ti出chu很hen多duo證zheng明ming。但dan是shi法fa官guan作zuo為wei一yi個ge非fei專zhuan業ye人ren士shi,在zai醫yi療liao方fang麵mian的de專zhuan業ye人ren士shi,仍reng然ran不bu能neng判pan斷duan,它ta是shi否fou有you過guo錯cuo。因yin為wei這zhe種zhong擔dan心xin應ying該gai說shuo是shi法fa院yuan確que實shi無wu法fa判pan斷duan他ta到dao底di有you沒mei有you過guo錯cuo,或huo者zhe是shi他ta到dao底di兩liang者zhe之zhi間jian是shi否fou存cun在zai一yi種zhong因yin果guo關guan係xi。我wo覺jiao得de這zhe是shi一yi種zhong醫yi學xue專zhuan業ye結jie論lun。法fa院yuan或huo者zhe法fa律lv涉she及ji到dao一yi個ge法fa律lv上shang爭zheng議yi的de問wen題ti。
zaizheyangdeqingkuangxia,daodishuiyingdangqushenqingjianding,zuoweiyuangao,huozheshihuanzhefang,tashouxianbuhuishenqing。yinwei,jiuzhegewenti,shishixingjuzhengzerendaozhi,yingdangyouyiyuandezhengming,ruguoyiyuanyebushenqing,youdefayuan,wozhidaodeqingkuang,fayuanzhudongtichulai,ruguoshangmiandangshirendoubujuzhengdeqingkuangxia,youdefayuanzaishijidangzhong,tayaoqiushuangfangdangshirengechuyibandejiandingfei,ranhouyoufayuanyizhiquanjiaoyouyixuehuijinxingjianding。zheshiguanyushibushiyinggaiyouyixuehuijiandingdewenti。
lingyigefangmian,fayuanruguodangshirenshuangfangdoubushenqingyixuehuijianding,yuangaofanghuozhehuanzhefangkebukeyishenqingsifajianding。huozheshuo,fayuankebukeyijiaoyousifajianding。anzhaowomenzhegetongzhideguiding,womenzhegetongzhijiangdeshishuo,renminfayuanzaiminshishenpanzhonggenjudangshirendeshenqinghuozheyizhiquanjuzhengjinxingyiliaoshigu,sifajiandingde,namejiangyoutiaolisuoguidingdeneirongjinxing。congzhegeguidinglaikan,yingdangshiyouyixuehuilaizuzhijianding。zhelimianwomenjiangdejiaoyiliaoshigusifajianding,namezhegeyinweizhishikaolvdao,jiushiwomenduisifajiandingdelijie,shizhifanshifayuanzaisusongguochengdangzhong,xuyaojianding,xuyaoweituotarenjiandingdezhezhongqingkuangdouchengzhiweisifajianding,zhegesifajianding,bingbuyiweizhedangrandejiaoyoufayuanxitong,huozheshiqitadeyouguandedanweisuozuodesifajianding。huanjuhuashuo,zhegesifajiandingbingbushizhiyixuehuiyiwaiderensuozuodejianding。
我wo再zai重zhong複fu一yi下xia,醫yi學xue會hui組zu織zhi鑒jian定ding,如ru果guo最zui終zhong鑒jian定ding的de責ze任ren不bu是shi醫yi療liao事shi故gu,是shi不bu是shi要yao再zai做zuo司si法fa鑒jian定ding。這zhe個ge問wen題ti休xiu息xi的de時shi候hou大da家jia都dou在zai爭zheng論lun。這zhe是shi一yi個ge小xiao問wen題ti。另ling外wai一yi個ge問wen題ti,醫yi療liao事shi故gu以yi外wai的de原yuan因yin由you誰shui來lai承cheng擔dan。我wo不bu知zhi道dao是shi舉ju證zheng責ze任ren的de承cheng擔dan,還hai是shi損sun害hai賠pei償chang的de承cheng擔dan。應ying該gai指zhi的de是shi舉ju證zheng責ze任ren的de承cheng擔dan。醫yi療liao事shi故gu以yi外wai的de原yuan因yin由you誰shui承cheng擔dan。這zhe個ge可ke能neng是shi說shuo,實shi際ji上shang這zhe個ge在zai醫yi療liao事shi故gu以yi外wai的de原yuan因yin的de理li解jie,如ru果guo我wo的de理li解jie,我wo剛gang才cai跟gen大da家jia的de理li解jie,不bu能neng籠long統tong地di說shuo由you誰shui來lai承cheng擔dan的de問wen題ti。在zai這zhe個ge問wen題ti上shang,組zu織zhi專zhuan家jia不bu能neng一yi概gai地di講jiang,是shi由you原yuan告gao方fang或huo者zhe患huan者zhe方fang,或huo者zhe說shuo由you醫yi療liao機ji構gou方fang的de診zhen斷duan。因yin為wei原yuan因yin是shi什shen麼me?如ru果guo說shuo,侵qin害hai隱yin私si權quan的de情qing況kuang下xia,應ying當dang是shi由you患huan者zhe來lai承cheng擔dan。當dang然ran我wo想xiang說shuo,醫yi療liao機ji構gou在zai一yi些xie違wei法fa的de情qing況kuang下xia造zao成cheng的de。因yin為wei我wo們men醫yi療liao事shi故gu處chu理li條tiao例li第di二er條tiao,對dui所suo有you的de醫yi療liao過guo失shi都dou有you一yi個ge違wei反fan的de前qian提ti,應ying該gai是shi違wei反fan行xing政zheng管guan理li等deng等deng,所suo有you的de行xing為wei都dou是shi違wei法fa的de。如ru果guo在zai故gu意yi的de情qing況kuang下xia,應ying該gai由you患huan者zhe來lai承cheng擔dan。
disangewentifayuandesifajiandingjigeinengfouzaiqisuqianshoulibushiyiliaoshigudeanjian,yiliaoguocuo,yinguoguanxideng。zhegewentishihennanhuidade。yinweizuigaofayuanzaiquniandeshihou,tongguoleyigeguanyuyiliaoguiding,youzhemeyigewenjian。womenqianmianyouyigesifajieshidexingshi,zhuanmenjiusifajiandingzuoleyigesifajieshi,zhegesifajiandingbaokuoyiliaofangmiande。anzhaozhegesifajieshi,yingdangshuoshikeyide。ruguoshianzhaowodelijie,bunengjinjiuyiliao,womenshenzhijiangdeshiyiliaoshigusifajiandingdehua,yingdangshiyouyixuehuilaizuzhi。yinweiwomendetongzhidiertiaojiangguo,yiliaoshigusifajiandingshiyoutiaoliguidingdeyixuehuizuzhijianding,danshianzhaoqianmiandesifajieshi,sifajiandingshikeyide。haiyouyigexiaowenti,yixuehuichujudeyiliaoshigubaogaoshuyoushuilaicanjiazhizheng,fayuandesifasifajiandingjigou,nengfouqingqiuyiliaoguoshiguocuoyinguoguanxiyinweituoyixuehuijinxingjianding。qianmianyigewenti,wojiaodeyingdangshiyoucanjiajianding 的(de)專(zhuan)家(jia)出(chu)庭(ting)執(zhi)政(zheng),既(ji)不(bu)是(shi)由(you)醫(yi)學(xue)會(hui)出(chu)麵(mian),也(ye)不(bu)是(shi)由(you)醫(yi)學(xue)會(hui)裏(li)麵(mian)的(de)具(ju)體(ti)工(gong)作(zuo)人(ren)員(yuan),組(zu)織(zhi)人(ren)員(yuan)很(hen)多(duo),有(you)的(de)醫(yi)療(liao)辦(ban)法(fa),鑒(jian)定(ding)辦(ban)給(gei)工(gong)作(zuo)人(ren)員(yuan)出(chu)庭(ting)。應(ying)當(dang)是(shi)由(you)參(can)加(jia)鑒(jian)定(ding)的(de)專(zhuan)家(jia)出(chu)庭(ting)。另(ling)外(wai)法(fa)院(yuan)的(de)司(si)法(fa)機(ji)構(gou)能(neng)否(fou)就(jiu)醫(yi)療(liao)過(guo)失(shi)進(jin)行(xing)鑒(jian)定(ding)。
我們衛生部,包括我們的條例對醫學會進行鑒定,它直接的規定是進行醫療事故鑒定。但是它沒有排除醫學會對醫療過失、過錯的因果關係鑒定。換句話說,我的理解是,如果是法院委托,醫學會願意接受,應該是可以的。
下(xia)麵(mian)的(de)一(yi)個(ge)問(wen)題(ti)是(shi)賠(pei)償(chang)的(de)問(wen)題(ti),醫(yi)療(liao)事(shi)故(gu)後(hou)期(qi)治(zhi)療(liao)費(fei)應(ying)當(dang)怎(zen)樣(yang)決(jue)定(ding),我(wo)們(men)條(tiao)例(li)的(de)規(gui)定(ding)是(shi)應(ying)該(gai)說(shuo),這(zhe)個(ge)條(tiao)例(li)就(jiu)醫(yi)療(liao)費(fei)用(yong)裏(li)麵(mian),規(gui)定(ding)後(hou)期(qi)治(zhi)療(liao)費(fei)應(ying)當(dang)包(bao)括(kuo)在(zai)醫(yi)療(liao)費(fei)裏(li)麵(mian),怎(zen)樣(yang)決(jue)定(ding)這(zhe)個(ge)條(tiao)例(li)沒(mei)有(you)規(gui)定(ding),但(dan)是(shi)在(zai)條(tiao)例(li)52tiaoguiding,yaoyicixing,yiliaoshigupeichangfeiyongshixingyicixingjiesuan,cunzaiyiliaoshiguzerendeyiliaozhidu。houxuzhiliaofeiyong,yingdangbaokuozaiyiliaofeilimian,yejiushishuo,xiangzheyangdeqingkuangxia,yingdangshiyoufayuanjinxinglongtongde,zheyigepanjuelimianjijiejueyijingfashengdefeiyong,yejiejuehouqidezhiliaofeiyong。danshizenyangjueding,najiudegenjuhuanzhe,yinweiyiliaoshiguzaochengdesunhai,jixuzhiliaodefeiyonglaijueding。zheshifeichangjishuxingdewenti。
因為這個條例第52條規定是一次性結算。實際上也可能,無論是對醫療機構,還是對患者,都可能產生不公平的情況。因為無論 是(shi)在(zai)需(xu)要(yao)後(hou)期(qi)治(zhi)療(liao)的(de)情(qing)況(kuang)下(xia),法(fa)院(yuan)在(zai)訴(su)訟(song)組(zu)織(zhi)判(pan)決(jue)的(de)時(shi)候(hou),並(bing)不(bu)能(neng)夠(gou)十(shi)分(fen)準(zhun)確(que)地(di)判(pan)斷(duan),後(hou)期(qi)治(zhi)療(liao)到(dao)底(di)需(xu)要(yao)多(duo)少(shao)費(fei)用(yong)。有(you)可(ke)能(neng)多(duo),有(you)可(ke)能(neng)少(shao)。下(xia)麵(mian)一(yi)個(ge)小(xiao)問(wen)題(ti)是(shi),鑒(jian)定(ding)結(jie)論(lun)在(zai)訴(su)訟(song)中(zhong)審(shen)查(zha)的(de)問(wen)題(ti)。鑒(jian)定(ding)結(jie)論(lun)不(bu)是(shi)醫(yi)療(liao)事(shi)故(gu),但(dan)是(shi)在(zai)具(ju)體(ti)分(fen)析(xi)事(shi)故(gu)的(de)過(guo)程(cheng)中(zhong),由(you)醫(yi)療(liao)單(dan)位(wei)在(zai)診(zhen)療(liao)過(guo)程(cheng)當(dang)中(zhong),有(you)一(yi)定(ding)的(de)過(guo)失(shi)行(xing)為(wei),法(fa)院(yuan)判(pan)決(jue)的(de)情(qing)況(kuang)。
我wo們men的de現xian實shi做zuo法fa,據ju我wo所suo知zhi,通tong常chang是shi,如ru果guo鑒jian定ding舉ju證zheng認ren為wei,應ying當dang是shi醫yi療liao機ji構gou在zai診zhen斷duan過guo程cheng當dang中zhong,有you一yi定ding的de過guo失shi行xing為wei。法fa院yuan通tong常chang會hui判pan定ding。但dan是shi按an照zhao這zhe個ge條tiao例li第di49條tiao第di二er款kuan規gui定ding是shi不bu承cheng擔dan的de。下xia一yi個ge小xiao問wen題ti,醫yi療liao事shi故gu鑒jian定ding的de費fei用yong。在zai判pan決jue中zhong,這zhe個ge判pan定ding由you誰shui來lai負fu擔dan。按an照zhao通tong常chang的de理li解jie,如ru果guo這zhe個ge鑒jian定ding,我wo覺jiao得de這zhe個ge問wen題ti也ye非fei常chang好hao,也ye非fei常chang難nan回hui答da。如ru果guo按an照zhao通tong常chang理li解jie的de話hua,鑒jian定ding這zhe不bu是shi醫yi療liao事shi故gu,那na麼me通tong常chang一yi方fang麵mian由you患huan者zhe來lai承cheng擔dan,但dan是shi我wo們men的de民min事shi訴su訟song規gui定ding,醫yi療liao機ji構gou負fu有you舉ju證zheng的de責ze任ren和he義yi務wu。醫yi療liao機ji構gou都dou應ying當dang有you責ze任ren認ren證zheng他ta們men的de過guo錯cuo。對dui他ta不bu承cheng擔dan責ze任ren做zuo出chu的de舉ju證zheng的de費fei用yong不bu是shi由you他ta來lai承cheng擔dan。我wo個ge人ren的de看kan法fa是shi,如ru果guo這zhe個ge醫yi療liao事shi故gu,這zhe個ge訴su訟song當dang中zhong,醫yi療liao事shi故gu鑒jian定ding,這zhe個ge鑒jian定ding不bu是shi醫yi療liao事shi故gu,並bing且qie也ye不bu會hui鑒jian定ding醫yi療liao機ji構gou的de醫yi療liao活huo動dong,患huan者zhe的de人ren身shen損sun害hai並bing不bu沒mei有you關guan係xi,這zhe種zhong情qing況kuang下xia由you患huan者zhe承cheng擔dan。如ru果guo鑒jian定ding不bu是shi醫yi療liao事shi故gu,當dang然ran應ying該gai有you醫yi療liao行xing為wei的de存cun在zai,問wen題ti是shi,不bu是shi醫yi療liao事shi故gu,但dan是shi醫yi療liao活huo動dong確que實shi存cun在zai一yi定ding的de過guo錯cuo。這zhe種zhong情qing況kuang下xia,鑒jian定ding費fei應ying該gai是shi由you醫yi療liao機ji構gou承cheng擔dan。當dang然ran這zhe裏li就jiu涉she及ji到dao一yi個ge非fei常chang麻ma煩fan的de問wen題ti,醫yi療liao機ji構gou承cheng擔dan這zhe些xie費fei用yong以yi後hou,它ta通tong常chang會hui打da入ru他ta的de成cheng分fen當dang中zhong,他ta會hui分fen散san到dao社she會hui當dang中zhong去qu,他ta會hui分fen散san到dao其qi他ta的de患huan者zhe身shen上shang。如ru果guo由you醫yi療liao機ji構gou承cheng擔dan所suo有you的de費fei用yong的de話hua,那na實shi際ji上shang就jiu會hui努nu力li讓rang患huan者zhe不bu正zheng當dang的de行xing使shi他ta的de訴su訟song權quan利li。
下(xia)麵(mian)一(yi)個(ge)小(xiao)問(wen)題(ti),同(tong)一(yi)案(an)件(jian)當(dang)中(zhong),上(shang)下(xia)級(ji)鑒(jian)定(ding)結(jie)論(lun)有(you)沒(mei)有(you)效(xiao)率(lv)高(gao)低(di)的(de)問(wen)題(ti)。這(zhe)隻(zhi)能(neng)說(shuo),從(cong)理(li)論(lun)上(shang)來(lai)講(jiang),鑒(jian)定(ding)結(jie)論(lun)應(ying)該(gai)沒(mei)有(you)效(xiao)率(lv)高(gao)低(di)的(de)問(wen)題(ti),但(dan)是(shi)按(an)照(zhao)我(wo)們(men)條(tiao)例(li)的(de)規(gui)定(ding),衛(wei)生(sheng)部(bu)的(de)行(xing)政(zheng)的(de)規(gui)章(zhang)也(ye)有(you)。因(yin)為(wei)我(wo)們(men)的(de)鑒(jian)定(ding)分(fen)一(yi)級(ji),審(shen)一(yi)級(ji),特(te)殊(shu)情(qing)況(kuang)下(xia),不(bu)應(ying)該(gai)組(zu)織(zhi)鑒(jian)定(ding)。從(cong)這(zhe)個(ge)行(xing)政(zheng)個(ge)別(bie)看(kan),它(ta)實(shi)際(ji)上(shang)是(shi)這(zhe)種(zhong)效(xiao)率(lv)高(gao)有(you)關(guan)係(xi)。如(ru)果(guo)是(shi)從(cong)上(shang)一(yi)級(ji)的(de)鑒(jian)定(ding)結(jie)構(gou),到(dao)下(xia)一(yi)級(ji)的(de)鑒(jian)定(ding)機(ji)構(gou)的(de)鑒(jian)定(ding)結(jie)論(lun)的(de)話(hua),應(ying)該(gai)采(cai)用(yong)上(shang)一(yi)級(ji)的(de)鑒(jian)定(ding)結(jie)構(gou)的(de)鑒(jian)定(ding)結(jie)論(lun)。這(zhe)是(shi)我(wo)的(de)理(li)解(jie)。
xiamiandewenti,shijishangqianmianyijingtanguo,zaipeichangguochengdangzhong,minshiguochengruguorending,sifajiandingzhouqinengfoudanxiang,zheshijishangjiangdeshiyigezuidadewenti。xiayigewentijiushishenliyiliaosunhaipeichanganjian,peichangcanzhaohezhongbiaozhun。zhelimian,wojiaodeshizheyangde。ruguoshiyiliaoshigudesunhaipeichanganjian,peichangbiaozhunjiucanzhaoyiliaoshiguchulitiaolideguidinglaijinxing。yiliaoshiguchulitiaolicongdi49條到52條tiao,對dui於yu這zhe個ge賠pei償chang標biao準zhun有you規gui定ding。雖sui然ran說shuo這zhe個ge權quan益yi上shang的de標biao準zhun,總zong體ti上shang看kan,都dou是shi比bi較jiao低di。而er且qie總zong體ti上shang看kan,都dou是shi限xian額e賠pei償chang。但dan是shi我wo們men最zui高gao人ren民min法fa院yuan這zhe個ge通tong知zhi已yi經jing明ming確que說shuo,因yin為wei醫yi療liao事shi故gu引yin起qi的de醫yi療liao賠pei償chang糾jiu紛fen民min事shi案an件jian,在zai人ren民min法fa院yuan在zai確que定ding醫yi療liao事shi故gu賠pei償chang責ze任ren時shi,參can照zhao條tiao例li的de規gui定ding辦ban理li。實shi際ji上shang是shi按an照zhao這zhe個ge條tiao例li從cong第di49條到第52條的來處理。這裏麵,從49條到52條,這裏規定還有一些具體問題的理解。這個需要再研究。
這zhe是shi因yin為wei醫yi療liao事shi故gu引yin起qi的de醫yi療liao損sun害hai賠pei償chang案an件jian,按an照zhao這zhe個ge標biao準zhun來lai做zuo。如ru果guo不bu是shi因yin為wei醫yi療liao事shi故gu引yin起qi的de損sun害hai賠pei償chang標biao準zhun,那na就jiu按an照zhao一yi般ban的de侵qin權quan標biao準zhun賠pei償chang原yuan則ze來lai處chu理li。因yin為wei非fei法fa行xing醫yi的de問wen題ti,因yin為wei醫yi療liao機ji構gou故gu意yi的de問wen題ti。應ying該gai是shi那na種zhong,侵qin權quan法fa所suo說shuo的de,前qian五wu個ge原yuan則ze來lai處chu理li。
zhegewentixiuxideshihou,youyigefayuandetongzhi,yeshuole,muqianzuigaofayuansifajieshi,xiangyiliaoshigupeichangjiufenanjiandangzhong,jizhengzerenyuyidaozhi,yiliaojigoujinxingjuzheng,zaishenlianjiandangzhong,yiliaojigoushenqingjianding,yiliaojigoujiandingyiliaoxingwuguocuo,zhenduanrenweifeizhuanyerenyuan,bunengweiguicaozuo。
我(wo)前(qian)麵(mian)已(yi)經(jing)說(shuo)過(guo)了(le),我(wo)可(ke)以(yi)補(bu)充(chong)一(yi)下(xia),如(ru)果(guo)醫(yi)療(liao)機(ji)構(gou)它(ta)沒(mei)有(you)申(shen)請(qing)鑒(jian)定(ding),但(dan)是(shi)它(ta)提(ti)供(gong)的(de)資(zi)料(liao)足(zu)以(yi)證(zheng)明(ming)它(ta)沒(mei)有(you)過(guo)錯(cuo),就(jiu)是(shi)說(shuo),這(zhe)個(ge)患(huan)者(zhe)根(gen)本(ben)就(jiu)沒(mei)有(you)辦(ban)法(fa)到(dao)醫(yi)院(yuan)就(jiu)診(zhen)過(guo),這(zhe)樣(yang)的(de)情(qing)況(kuang)下(xia)就(jiu)不(bu)需(xu)要(yao)去(qu)鑒(jian)定(ding),換(huan)句(ju)話(hua)說(shuo),如(ru)果(guo)是(shi)醫(yi)院(yuan)能(neng)證(zheng)明(ming)這(zhe)個(ge)患(huan)者(zhe),這(zhe)件(jian)事(shi)就(jiu)診(zhen)過(guo),但(dan)是(shi)醫(yi)院(yuan)能(neng)證(zheng)明(ming),他(ta)沒(mei)有(you)完(wan)全(quan),或(huo)者(zhe)完(wan)全(quan)沒(mei)有(you),按(an)照(zhao)醫(yi)生(sheng)的(de)囑(zhu)咐(fu)來(lai)吃(chi)藥(yao)或(huo)者(zhe)治(zhi)療(liao)的(de)話(hua),這(zhe)種(zhong)情(qing)況(kuang)就(jiu)涉(she)及(ji)到(dao)一(yi)個(ge)具(ju)體(ti)判(pan)定(ding)的(de)問(wen)題(ti)。人(ren)按(an)照(zhao)通(tong)常(chang)的(de)標(biao)準(zhun),雖(sui)然(ran)審(shen)判(pan)人(ren)員(yuan)不(bu)是(shi)專(zhuan)業(ye)人(ren)員(yuan),但(dan)是(shi)能(neng)判(pan)斷(duan)出(chu)來(lai),這(zhe)個(ge)過(guo)錯(cuo),或(huo)者(zhe)是(shi)完(wan)全(quan)在(zai)於(yu)患(huan)者(zhe)的(de)話(hua),我(wo)想(xiang)也(ye)不(bu)一(yi)定(ding)非(fei)得(de)有(you)醫(yi)療(liao)機(ji)構(gou)申(shen)請(qing)鑒(jian)定(ding)。這(zhe)是(shi)一(yi)種(zhong)情(qing)況(kuang)。一(yi)般(ban)的(de)情(qing)況(kuang)下(xia)是(shi)判(pan)定(ding)出(chu)來(lai)。
gengweiduodeqingkuangxia,zuoweishenpanrenyuan,tadeyixiewentigenbenbudong,yiyuandenaxiechenshuzhengming,wojiuwufapanduan,zheyangdeqingkuangxia,ruguoshiyiyuanbuqushenqingjianding,nameyouliangzhongbanfa,yizhongbanfashianzhaotuijiefangdeguocuo。lingyizhongbanfashiyixuezhiquan,jiangzhegeanjianjiaoyouyixuehuilaizuzhijianding。zhegewentishejidaoqianmianjiangdeyiliaofeiyongfudanwenti。
xiamianjiushishuo,genjutiaoyan,xialiefanyingzaichuliyiliaopeichanganjianzhong,zainongcun,cunweishengshidabudaoguayidemingyi。weishengshiyoudeyouzhixingzhiyexukezheng,dangranyoudeshimeiyou,fashengjiufendeshihou,youyigedaibiaodewenti。danwojiaodeshizheyangde,ruguoshiguakaodehua,nawogerendekanfashi,yingdangbaguakaogeiweishengshihuozheshibeiguakaoweishengbudoukeyirenweiweifa。yinweitawanquanshigerenchengbaogenmeiyouguahaodehua,namejiushitagerenzuoweibeigao。zheshiyizhongqingkuang。
ruguoshiweishengshimeiyouzhixingxukezheng,namejiuwanquanshiweishengshizijiyinggaichengdanzerendewenti。lingwaiyigexiangfa,shinongcunweishengshibuxiebingli,bukaifapiao,shifouyoujuzhengzerendaozhirendingshuangfangcunzaiyihuanguanxi。
按(an)照(zhao)醫(yi)療(liao)事(shi)故(gu)條(tiao)例(li)的(de)規(gui)定(ding),書(shu)寫(xie)病(bing)例(li)是(shi)醫(yi)療(liao)機(ji)構(gou)的(de)責(ze)任(ren)和(he)義(yi)務(wu)。如(ru)果(guo)他(ta)不(bu)書(shu)寫(xie)認(ren)定(ding),但(dan)是(shi)患(huan)者(zhe)通(tong)過(guo)醫(yi)療(liao)機(ji)構(gou),衛(wei)生(sheng)室(shi)開(kai)出(chu)的(de)發(fa)票(piao)證(zheng)明(ming)他(ta)存(cun)在(zai)醫(yi)患(huan)關(guan)係(xi),這(zhe)個(ge)可(ke)以(yi)運(yun)用(yong)舉(ju)證(zheng)責(ze)任(ren)倒(dao)置(zhi)存(cun)在(zai)雙(shuang)方(fang)存(cun)在(zai)醫(yi)患(huan)關(guan)係(xi)。作(zuo)為(wei)一(yi)般(ban)人(ren)從(cong)醫(yi)衛(wei)生(sheng)室(shi)得(de)到(dao)一(yi)個(ge)發(fa)票(piao),他(ta)應(ying)該(gai)來(lai)說(shuo),不(bu)會(hui)發(fa)生(sheng)其(qi)他(ta)的(de)關(guan)係(xi)。那(na)麼(me)衛(wei)生(sheng)室(shi)無(wu)論(lun)是(shi)從(cong)衛(wei)生(sheng)室(shi)買(mai)藥(yao),還(hai)是(shi)從(cong)衛(wei)生(sheng)室(shi)看(kan)病(bing),他(ta)都(dou)應(ying)當(dang)有(you)詳(xiang)細(xi)的(de)書(shu)寫(xie)記(ji)錄(lu)。看(kan)病(bing)這(zhe)個(ge)病(bing)例(li),買(mai)藥(yao)也(ye)有(you)病(bing)例(li)。但(dan)不(bu)是(shi)藥(yao)店(dian),如(ru)果(guo)說(shuo)患(huan)者(zhe)是(shi)從(cong)為(wei)人(ren)舉(ju)證(zheng)進(jin)行(xing)其(qi)他(ta)的(de)效(xiao)益(yi)。通(tong)過(guo)別(bie)的(de)關(guan)係(xi),那(na)這(zhe)個(ge)應(ying)該(gai)由(you)衛(wei)生(sheng)室(shi)來(lai)證(zheng)明(ming)。
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還(hai)有(you)一(yi)個(ge)問(wen)題(ti)說(shuo),雙(shuang)方(fang)經(jing)過(guo)申(shen)請(qing)鑒(jian)定(ding),法(fa)院(yuan)可(ke)進(jin)行(xing)鑒(jian)定(ding),醫(yi)療(liao)事(shi)故(gu)鑒(jian)定(ding)訴(su)訟(song)前(qian)沒(mei)有(you)申(shen)請(qing),訴(su)訟(song)中(zhong),申(shen)請(qing)鑒(jian)定(ding),申(shen)請(qing)醫(yi)療(liao)事(shi)故(gu)鑒(jian)定(ding)是(shi)受(shou)司(si)法(fa)鑒(jian)定(ding)限(xian)製(zhi)。
因yin為wei醫yi學xue會hui就jiu是shi鑒jian定ding,並bing不bu是shi說shuo都dou必bi須xu在zai訴su訟song前qian,在zai訴su訟song過guo程cheng當dang中zhong同tong樣yang是shi可ke以yi的de,按an照zhao醫yi療liao事shi故gu見jian證zheng條tiao例li的de規gui定ding,見jian證zheng有you三san種zhong發fa生sheng的de方fang式shi。一yi種zhong是shi醫yi患huan雙shuang方fang共gong同tong協xie商shang,共gong同tong申shen請qing。二er種zhong是shi衛wei生sheng行xing政zheng主zhu管guan部bu門men交jiao由you,三san是shi法fa院yuan交jiao由you鑒jian定ding。那na麼me在zai訴su訟song當dang中zhong這zhe個ge問wen題ti是shi司si法fa鑒jian定ding。司si法fa鑒jian定ding實shi際ji上shang是shi由you當dang時shi申shen請qing規gui劃hua,委wei托tuo這zhe個ge鑒jian定ding。如ru果guo訴su訟song前qian沒mei有you鑒jian定ding,訴su訟song當dang中zhong,當dang事shi人ren申shen請qing鑒jian定ding,法fa院yuan在zai審shen理li當dang中zhong,無wu論lun是shi由you法fa院yuan依yi職zhi權quan鑒jian定ding,還hai是shi由you當dang事shi人ren申shen請qing鑒jian定ding。我wo想xiang都dou應ying當dang等deng到dao這zhe個ge鑒jian定ding結jie論lun出chu來lai以yi後hou,才cai進jin行xing繼ji續xu審shen理li。
還(hai)有(you)一(yi)個(ge)問(wen)題(ti)。這(zhe)是(shi)一(yi)個(ge)相(xiang)關(guan)的(de)問(wen)題(ti)。第(di)五(wu)運(yun)行(xing)當(dang)中(zhong),按(an)照(zhao)婚(hun)姻(yin)法(fa)規(gui)定(ding)條(tiao)例(li)規(gui)定(ding),婚(hun)檢(jian)機(ji)構(gou)隻(zhi)是(shi)鑒(jian)於(yu)某(mou)些(xie)人(ren)是(shi)否(fou)適(shi)宜(yi)結(jie)婚(hun)。也(ye)就(jiu)是(shi)說(shuo),婚(hun)檢(jian)的(de)鑒(jian)定(ding),按(an)照(zhao)法(fa)律(lv)的(de)規(gui)定(ding),它(ta)是(shi)鑒(jian)定(ding)婚(hun)姻(yin)法(fa)所(suo)規(gui)定(ding),或(huo)者(zhe)是(shi)婚(hun)姻(yin)登(deng)記(ji)機(ji)關(guan)的(de)條(tiao)例(li)規(gui)定(ding)不(bu)宜(yi)結(jie)婚(hun)的(de)情(qing)況(kuang),這(zhe)個(ge)應(ying)該(gai)是(shi)由(you)衛(wei)生(sheng)部(bu)來(lai)明(ming)確(que)規(gui)定(ding)。
像xiang這zhe裏li提ti到dao的de這zhe種zhong情qing況kuang,如ru果guo不bu是shi說shuo,婚hun姻yin法fa所suo規gui定ding的de應ying當dang檢jian查zha的de情qing況kuang,那na麼me婚hun檢jian機ji構gou出chu具ju這zhe方fang麵mian的de證zheng明ming,是shi否fou在zai這zhe種zhong情qing況kuang下xia,當dang時shi人ren能neng不bu能neng訴su訟song到dao法fa院yuan去qu。我wo想xiang是shi這zhe樣yang的de。第di一yi,起qi訴su到dao法fa院yuan去qu,應ying該gai是shi可ke以yi的de。因yin為wei按an照zhao婚hun姻yin法fa的de規gui定ding,這zhe種zhong婚hun檢jian是shi一yi種zhong必bi須xu進jin行xing的de。這zhe個ge應ying該gai是shi從cong一yi定ding的de情qing況kuang下xia,有you點dian類lei似si於yu委wei托tuo或huo者zhe是shi授shou受shou的de關guan係xi,從cong這zhe個ge意yi義yi上shang講jiang,這zhe種zhong性xing質zhi應ying該gai是shi一yi種zhong民min事shi糾jiu紛fen。至zhi於yu說shuo法fa院yuan能neng不bu能neng支zhi持chi,這zhe是shi另ling外wai一yi個ge問wen題ti。如ru果guo按an照zhao法fa律lv的de規gui定ding。不bu受shou婚hun前qian的de範fan圍wei,法fa律lv應ying該gai支zhi持chi。如ru果guo屬shu於yu婚hun檢jian的de情qing況kuang,婚hun檢jian方fang麵mian應ying該gai承cheng擔dan責ze任ren。
下xia麵mian一yi個ge問wen題ti,醫yi學xue鑒jian定ding結jie論lun訴su訟song當dang中zhong,是shi否fou進jin行xing執zhi政zheng,這zhe個ge爭zheng議yi事shi項xiang法fa院yuan如ru何he處chu理li。按an照zhao民min事shi訴su訟song當dang中zhong正zheng確que的de做zuo了le規gui定ding,任ren何he一yi個ge鑒jian定ding結jie論lun都dou進jin行xing舉ju證zheng,沒mei有you進jin行xing執zhi政zheng的de不bu能neng作zuo為wei定ding案an的de依yi據ju,醫yi療liao事shi故gu鑒jian定ding,我wo們men的de法fa院yuan設she立li的de或huo者zhe是shi其qi他ta機ji構gou司si法fa鑒jian定ding,以yi及ji單dan位wei所suo做zuo的de鑒jian定ding結jie論lun,都dou應ying當dang改gai正zheng。法fa院yuan應ying該gai通tong常chang按an照zhao責ze任ren式shi審shen查zha,這zhe個ge鑒jian定ding結jie論lun所suo得de出chu的de全quan細xi。我wo想xiang不bu應ying當dang是shi法fa院yuan辦ban的de事shi情qing。當dang人ren們men正zheng式shi鑒jian定ding結jie論lun,確que實shi存cun在zai層ceng次ci上shang的de問wen題ti。我wo想xiang這zhe應ying該gai是shi可ke以yi再zai次ci鑒jian定ding。醫yi院yuan會hui申shen請qing再zai次ci鑒jian定ding。
再zai一yi個ge問wen題ti,病bing例li,舉ju證zheng責ze任ren分fen配pei,這zhe個ge問wen題ti是shi不bu是shi說shuo,有you一yi個ge患huan者zhe從cong醫yi院yuan裏li麵mian搶qiang的de病bing例li,一yi個ge醫yi院yuan從cong患huan者zhe保bao留liu了le,如ru果guo患huan者zhe從cong醫yi院yuan保bao存cun的de病bing例li當dang中zhong,我wo想xiang這zhe得de考kao察cha具ju體ti案an件jian的de情qing況kuang。我wo講jiang這zhe個ge情qing況kuang,提ti問wen的de真zhen實shi性xing。再zai有you醫yi院yuan的de一yi個ge問wen題ti。這zhe個ge是shi前qian麵mian多duo次ci提ti到dao的de問wen題ti。法fa院yuan這zhe種zhong情qing況kuang下xia,醫yi療liao機ji構gou隻zhi能neng提ti起qi上shang訴su了le。
下(xia)麵(mian)一(yi)句(ju)話(hua),對(dui)不(bu)是(shi)醫(yi)療(liao)事(shi)故(gu),有(you)輕(qing)微(wei)後(hou)果(guo),但(dan)是(shi)與(yu)後(hou)果(guo)無(wu)關(guan),也(ye)會(hui)構(gou)成(cheng)任(ren)何(he)侵(qin)權(quan),醫(yi)療(liao)機(ji)構(gou)是(shi)否(fou)也(ye)要(yao)賠(pei)償(chang)。這(zhe)種(zhong)情(qing)況(kuang)醫(yi)療(liao)機(ji)構(gou)肯(ken)定(ding)不(bu)賠(pei)償(chang),因(yin)為(wei)它(ta)沒(mei)有(you)構(gou)成(cheng)任(ren)何(he)侵(qin)權(quan)。沒(mei)有(you)侵(qin)權(quan)當(dang)然(ran)不(bu)承(cheng)擔(dan)責(ze)任(ren)。這(zhe)個(ge)提(ti)問(wen)本(ben)身(shen)可(ke)能(neng)說(shuo),不(bu)是(shi)醫(yi)療(liao)事(shi)故(gu),但(dan)是(shi)醫(yi)療(liao)機(ji)構(gou)確(que)實(shi)存(cun)在(zai)某(mou)方(fang)麵(mian)的(de)問(wen)題(ti),當(dang)然(ran)這(zhe)個(ge)問(wen)題(ti),如(ru)果(guo)沒(mei)有(you)任(ren)何(he)關(guan)係(xi)的(de)話(hua),當(dang)然(ran)不(bu)應(ying)該(gai)承(cheng)擔(dan)任(ren)何(he)的(de)責(ze)任(ren)。下(xia)麵(mian)醫(yi)院(yuan)的(de)建(jian)議(yi),醫(yi)療(liao)行(xing)為(wei)賠(pei)償(chang)和(he)民(min)事(shi)賠(pei)償(chang)有(you)如(ru)何(he)不(bu)同(tong),在(zai)高(gao)院(yuan)司(si)法(fa)解(jie)釋(shi)中(zhong)沒(mei)有(you)顯(xian)現(xian)出(chu)不(bu)是(shi)醫(yi)療(liao)事(shi)故(gu)的(de)不(bu)賠(pei)償(chang)。醫(yi)療(liao)機(ji)構(gou)的(de)理(li)解(jie)。我(wo)隻(zhi)能(neng)說(shuo)按(an)照(zhao)醫(yi)療(liao)事(shi)故(gu)處(chu)理(li)條(tiao)例(li)的(de)規(gui)定(ding)所(suo)做(zuo)出(chu)來(lai)的(de)賠(pei)償(chang),按(an)照(zhao)民(min)法(fa)通(tong)則(ze)的(de)規(gui)定(ding)所(suo)做(zuo)出(chu)的(de)賠(pei)償(chang),這(zhe)兩(liang)個(ge)責(ze)任(ren)確(que)實(shi)有(you)很(hen)大(da)的(de)不(bu)同(tong)。就(jiu)是(shi)說(shuo),一(yi)個(ge)是(shi)賠(pei)償(chang)範(fan)圍(wei)的(de)不(bu)同(tong),醫(yi)療(liao)事(shi)故(gu)的(de)處(chu)理(li)條(tiao)例(li)規(gui)定(ding)的(de)是(shi)現(xian)有(you)的(de)賠(pei)償(chang)。另(ling)外(wai)一(yi)個(ge)規(gui)定(ding)基(ji)本(ben)上(shang)都(dou)是(shi)項(xiang)目(mu)賠(pei)償(chang)。
然ran後hou鑒jian定ding的de過guo程cheng當dang中zhong,引yin起qi這zhe麼me大da的de爭zheng論lun,我wo想xiang最zui高gao法fa院yuan在zai以yi後hou的de司si法fa解jie釋shi當dang中zhong,肯ken定ding會hui或huo者zhe說shuo應ying當dang會hui對dui這zhe個ge問wen題ti進jin行xing進jin一yi步bu的de明ming確que。下xia麵mian有you一yi個ge曆li史shi問wen題ti是shi,構gou不bu成cheng醫yi療liao事shi故gu的de案an件jian,認ren為wei是shi侵qin權quan,或huo者zhe是shi違wei法fa。這zhe個ge問wen題ti跟gen前qian麵mian的de問wen題ti是shi一yi樣yang的de。這zhe是shi原yuan來lai的de問wen題ti。
下xia一yi個ge問wen題ti,作zuo為wei醫yi療liao事shi故gu鑒jian定ding,實shi踐jian證zheng明ming,多duo數shu醫yi院yuan搞gao的de鑒jian定ding,如ru果guo不bu通tong過guo司si法fa鑒jian定ding和he醫yi學xue會hui錯cuo誤wu鑒jian定ding,如ru何he糾jiu正zheng?如ru果guo不bu走zou司si法fa鑒jian定ding,僅jin僅jin是shi按an照zhao條tiao例li的de規gui定ding,三san級ji醫yi療liao醫yi學xue會hui要yao求qiu完wan了le,可ke能neng沒mei有you做zuo。這zhe不bu是shi一yi個ge開kai玩wan笑xiao的de話hua,任ren何he一yi個ge程cheng序xu,或huo者zhe任ren何he一yi個ge製zhi度du,可ke能neng都dou不bu會hui十shi全quan十shi美mei。任ren何he一yi個ge製zhi度du肯ken定ding都dou有you一yi個ge製zhi度du本ben身shen的de代dai價jia,或huo者zhe任ren何he一yi個ge規gui範fan本ben身shen都dou會hui存cun在zai一yi個ge問wen題ti。這zhe個ge問wen題ti等deng於yu說shuo,像xiang我wo們men經jing常chang會hui遇yu到dao的de問wen題ti,法fa院yuan規gui定ding兩liang審shen終zhong審shen,兩liang審shen完wan了le再zai審shen。仍reng然ran是shi當dang事shi人ren對dui法fa院yuan的de裁cai判pan結jie果guo不bu服fu。我wo們men是shi不bu是shi應ying當dang繼ji續xu不bu停ting地di再zai審shen。對dui於yu正zheng確que與yu否fou,或huo者zhe是shi是shi不bu是shi錯cuo誤wu,不bu同tong的de人ren有you不bu同tong的de評ping價jia標biao準zhun。
第(di)二(er),下(xia)一(yi)個(ge)問(wen)題(ti),有(you)因(yin)果(guo)關(guan)係(xi)的(de)醫(yi)療(liao)過(guo)錯(cuo),醫(yi)療(liao)鑒(jian)定(ding),大(da)事(shi)化(hua)小(xiao),小(xiao)事(shi)化(hua)了(le),怎(zen)麼(me)解(jie)決(jue)。根(gen)本(ben)上(shang)的(de)解(jie)決(jue)辦(ban)法(fa)就(jiu)是(shi)說(shuo),我(wo)們(men)這(zhe)個(ge)條(tiao)例(li)實(shi)施(shi)一(yi)段(duan)時(shi)間(jian)以(yi)後(hou),由(you)全(quan)國(guo)人(ren)大(da)立(li)法(fa)解(jie)決(jue)。如(ru)何(he)通(tong)過(guo)立(li)法(fa)解(jie)決(jue)呢(ne)?就(jiu)是(shi)說(shuo),它(ta)無(wu)論(lun)是(shi)規(gui)定(ding)一(yi)種(zhong)什(shen)麼(me)模(mo)式(shi),換(huan)句(ju)話(hua)說(shuo),無(wu)論(lun)是(shi)把(ba)現(xian)在(zai)這(zhe)個(ge)條(tiao)例(li)規(gui)定(ding)的(de)這(zhe)種(zhong)模(mo)式(shi)上(shang)升(sheng)成(cheng)為(wei)立(li)法(fa),還(hai)是(shi)完(wan)全(quan)否(fou)定(ding)這(zhe)個(ge)條(tiao)例(li)。基(ji)本(ben)上(shang)人(ren)案(an)立(li)法(fa)作(zuo)為(wei)一(yi)個(ge)特(te)別(bie)法(fa)的(de)規(gui)定(ding)。那(na)麼(me)在(zai)這(zhe)樣(yang)的(de)情(qing)況(kuang)下(xia)。我(wo)們(men)就(jiu)是(shi)按(an)照(zhao)個(ge)別(bie)法(fa)的(de)規(gui)定(ding)來(lai)處(chu)理(li)。這(zhe)樣(yang)的(de)情(qing)況(kuang)下(xia),仍(reng)然(ran)會(hui)存(cun)在(zai)這(zhe)樣(yang)的(de)情(qing)況(kuang)。這(zhe)個(ge)確(que)實(shi)沒(mei)有(you)辦(ban)法(fa)解(jie)決(jue)。
還有很多問題。假如1993年7月1號,國家衛生部管理辦法實施條例,醫院輸入的血含有乙肝病毒,管理條例第33條,34條的條件。第33條三項是這樣的,現有醫學會的技術,第四項患者輸血感染。因為我前麵介紹過,就是這個醫療事故條例第33條(tiao),第(di)三(san)項(xiang)的(de)理(li)解(jie),現(xian)有(you)醫(yi)學(xue)科(ke)學(xue)技(ji)術(shu)條(tiao)件(jian),這(zhe)是(shi)一(yi)個(ge)非(fei)常(chang)籠(long)統(tong)的(de)一(yi)般(ban)的(de)免(mian)責(ze)事(shi)由(you)。因(yin)為(wei)盡(jin)管(guan)我(wo)們(men)說(shuo),這(zhe)是(shi)我(wo)們(men)國(guo)務(wu)院(yuan)關(guan)於(yu)行(xing)政(zheng)法(fa)規(gui),換(huan)句(ju)話(hua)說(shuo),對(dui)現(xian)有(you)的(de)科(ke)學(xue)技(ji)術(shu)的(de)判(pan)斷(duan),隻(zhi)能(neng)局(ju)限(xian)於(yu)我(wo)們(men)中(zhong)國(guo)的(de)情(qing)況(kuang)。那(na)麼(me)如(ru)果(guo)按(an)照(zhao)這(zhe)麼(me)一(yi)個(ge)理(li)解(jie)的(de)話(hua),如(ru)果(guo)中(zhong)國(guo)的(de)國(guo)內(nei)的(de)所(suo)有(you)的(de)醫(yi)療(liao)及(ji)給(gei)或(huo)者(zhe)是(shi)醫(yi)生(sheng),醫(yi)務(wu)工(gong)作(zuo)者(zhe)人(ren)員(yuan),他(ta)所(suo)能(neng)采(cai)取(qu)的(de),或(huo)者(zhe)是(shi)所(suo)能(neng)掌(zhang)握(wo)的(de)醫(yi)學(xue)科(ke)學(xue)技(ji)術(shu),仍(reng)然(ran)不(bu)能(neng)避(bi)免(mian)這(zhe)種(zhong)情(qing)況(kuang)發(fa)生(sheng)的(de)話(hua)。那(na)是(shi)不(bu)應(ying)當(dang)承(cheng)擔(dan)責(ze)任(ren)的(de)。
wojiaodejiujutiqingkuangeryan,bunengzhemelijie。disixiang,youwuguocuoshuxueganran,henduoqingkuangxia,genguocuoshuxueganranzhongdeguidingjiuyouyixiegerenyijianbutong,suoyiwobuhaohuidanizhegewenti。woyaogaosuni,womenzuigaorenminfayuanxianzaishenpanweiyuanhuitaolunzhegewenti,yinshuxueyinqideganranbinggan,aizibingdujiqitachuanranxingjibingdezhemeyigewenti。yijingyousifajieshi,zhegesifajieshiyijingzaidengdai。zhegesifajieshikendinghuihuidanitichudezhegewenti。
xiamianyigewentishi,fayuanqixing,huozheshijiandingbuchulai,sifabumenbupei。jiandingbuchulai,wojiaodekenengyouliangzhongqingkuang,yigeshigenjuxianyoudecailiaobunengpanduan,yizhongqingkuangshisuopeizhiqian,zhegecailiaobuxing,houyizhongqingkuangshifayuanhuozheyouguandangshiren,yingdangtigongfuheyaoqiudecailiao,huoshouxu。ruguoqianyizhongqingkuangbijiaomafanle。yinweiwomengangcaiqianmiantandaojuzhengzerendeshihou,anzhaowomenjizhengzerendezhengjuguiding,yinggaishiyouyiliaojigouzhengmingtameiyouguocuo,meiyouyinguoguanxi。namejiandingbuchulai,nakenengjiuyiweizheyiliaojigouzijibunengzhengming,tadeyiliaohuodonghehuanzhederenshensunhai,shifouyouyinguoguanxi。
zheshiyigehenzaodewenti,yijingyiqianjingguoyixuehuijiandingbushiyiliaoshigu,yuangaoshenqingfayuanduiyiliaochacuozuosifajianding,fayuanyunxu,yigeshizhegeyiyuanyiyouxiaozhengjutuifansifajiedingdejielun,yuangaoyoushenqingqishanghaidesifajianding,daozhianjianchangjiubupan,zhegezuofashifouzhengque。shijishangbunenglongtongdihuidazhengquehuozheshicuowu。dangranshiyinweizhegetiaoli debutongerbutong。anzhaowodelijiekenengshibutongde,ruguoandajiadelijie,huozheshihenduorendelijie。anzhaolingwaiyigeqingkuang,fayuanjinkenengdizhengquzhegeanjiandezhenshixing,yebunengrenweitashicuowude。
如果按照合同法的規定,侵權訴訟,選擇侵權不存在。五
另(ling)外(wai)一(yi)個(ge)問(wen)題(ti),對(dui)醫(yi)患(huan)關(guan)係(xi)到(dao)底(di)是(shi)合(he)同(tong)關(guan)係(xi),還(hai)是(shi)服(fu)務(wu)關(guan)係(xi),它(ta)是(shi)一(yi)種(zhong)責(ze)任(ren)合(he)同(tong)關(guan)係(xi),也(ye)是(shi)存(cun)在(zai)爭(zheng)議(yi)的(de)。因(yin)為(wei)從(cong)我(wo)們(men)現(xian)在(zai)的(de)醫(yi)療(liao)事(shi)故(gu)處(chu)理(li)條(tiao)例(li)的(de)規(gui)定(ding)看(kan),我(wo)覺(jiao)得(de)它(ta)沒(mei)有(you)把(ba)醫(yi)患(huan)關(guan)係(xi)規(gui)定(ding)為(wei)一(yi)種(zhong)合(he)同(tong)關(guan)係(xi)。再(zai)一(yi)個(ge)問(wen)題(ti)是(shi),醫(yi)院(yuan)搶(qiang)救(jiu)急(ji)診(zhen)病(bing)人(ren)時(shi),病(bing)人(ren)沒(mei)有(you)掛(gua)號(hao),沒(mei)有(you)付(fu)費(fei),我(wo)覺(jiao)得(de)這(zhe)種(zhong)事(shi)情(qing)是(shi)說(shuo),如(ru)果(guo)僅(jin)僅(jin)是(shi)從(cong)醫(yi)療(liao)事(shi)故(gu)處(chu)理(li)條(tiao)例(li)第(di)33條(tiao)的(de)規(gui)定(ding)。出(chu)現(xian)這(zhe)種(zhong)情(qing)況(kuang),法(fa)院(yuan)是(shi)不(bu)構(gou)成(cheng)侵(qin)權(quan)的(de)。我(wo)覺(jiao)得(de)醫(yi)院(yuan)在(zai)搶(qiang)救(jiu)急(ji)診(zhen)病(bing)人(ren)時(shi),應(ying)當(dang)注(zhu)意(yi)的(de),應(ying)當(dang)申(shen)請(qing)多(duo)數(shu)人(ren),通(tong)常(chang)情(qing)況(kuang)下(xia)應(ying)該(gai)遵(zun)守(shou)這(zhe)個(ge)規(gui)定(ding),隻(zhi)有(you)在(zai)這(zhe)兩(liang)個(ge)條(tiao)件(jian)符(fu)合(he)以(yi)後(hou),那(na)麼(me)它(ta)才(cai)可(ke)以(yi)。否(fou)則(ze)的(de)話(hua),對(dui)患(huan)者(zhe)是(shi)極(ji)大(da)的(de)不(bu)公(gong)平(ping),造(zao)成(cheng)醫(yi)療(liao)機(ji)構(gou)的(de)極(ji)端(duan)不(bu)負(fu)責(ze)任(ren)。
下xia一yi個ge問wen題ti是shi說shuo,醫yi療liao行xing為wei的de侵qin害hai過guo程cheng的de後hou果guo,在zai法fa律lv上shang的de規gui定ding。如ru果guo醫yi療liao行xing為wei有you過guo失shi,但dan沒mei有you錯cuo誤wu,我wo理li解jie這zhe個ge後hou果guo指zhi的de是shi沒mei有you人ren身shen損sun害hai這zhe方fang麵mian的de後hou果guo,我wo們men認ren為wei,這zhe個ge沒mei有you後hou果guo。這zhe就jiu涉she及ji到dao前qian麵mian一yi個ge問wen題ti。這zhe個ge就jiu比bi較jiao複fu雜za。如ru果guo把ba它ta理li解jie為wei醫yi患huan關guan係xi是shi一yi種zhong合he同tong關guan係xi,這zhe個ge合he同tong關guan係xi有you明ming確que的de約yue定ding說shuo。醫yi院yuan隻zhi要yao是shi有you違wei約yue就jiu要yao承cheng擔dan責ze任ren的de話hua,那na麼me當dang然ran它ta有you很hen大da的de責ze任ren。如ru果guo不bu是shi特te別bie明ming顯xian,不bu是shi合he同tong關guan係xi,而er是shi認ren為wei是shi一yi種zhong按an照zhao條tiao例li的de規gui定ding,或huo者zhe是shi一yi般ban的de規gui定ding來lai講jiang,它ta的de侵qin權quan觀guan念nian來lai理li解jie的de話hua,這zhe個ge就jiu有you問wen題ti。
這裏有一個問題,醫療事故當中的處理費或殘疾器具費的賠償年限,以30年為限。我們的條例,我認為是這樣的,這個問題的認為,我覺得是這樣的,如果是醫院,它進入護理費30年為限。沒有規定,沒有以30年nian為wei限xian。這zhe裏li麵mian,如ru果guo是shi這zhe個ge人ren年nian限xian非fei常chang之zhi長chang,那na應ying該gai另ling外wai處chu理li。像xiang我wo們men的de審shen判pan當dang中zhong,有you這zhe個ge條tiao例li的de建jian設she是shi一yi次ci性xing結jie算suan,實shi際ji上shang很hen難nan判pan斷duan。那na麼me隻zhi能neng是shi有you一yi個ge通tong常chang的de規gui定ding。通tong常chang的de判pan斷duan。那na我wo個ge人ren的de看kan法fa是shi,可ke以yi參can照zhao殘can疾ji人ren生sheng活huo補bu助zhu費fei的de規gui定ding。
下(xia)麵(mian)的(de)問(wen)題(ti)跟(gen)前(qian)麵(mian)的(de)問(wen)題(ti)是(shi)一(yi)樣(yang)的(de),患(huan)者(zhe)醫(yi)療(liao)事(shi)故(gu)造(zao)成(cheng)殘(can)疾(ji)。籠(long)統(tong)地(di)說(shuo),我(wo)的(de)理(li)解(jie),現(xian)在(zai)這(zhe)個(ge)條(tiao)例(li)的(de)規(gui)定(ding),如(ru)果(guo)是(shi)因(yin)為(wei)醫(yi)療(liao)事(shi)故(gu)造(zao)成(cheng)患(huan)者(zhe)終(zhong)身(shen)殘(can)疾(ji),生(sheng)活(huo)不(bu)能(neng)自(zi)理(li),就(jiu)賠(pei)付(fu)費(fei)包(bao)括(kuo)殘(can)疾(ji)用(yong)具(ju)費(fei)的(de)年(nian)限(xian)計(ji)算(suan)來(lai)說(shuo),我(wo)覺(jiao)得(de)可(ke)能(neng)應(ying)該(gai)按(an)照(zhao)人(ren)的(de)平(ping)均(jun)壽(shou)命(ming)來(lai)判(pan)斷(duan)。因(yin)為(wei)我(wo)們(men)在(zai)條(tiao)例(li)第(di)50條tiao,他ta僅jin僅jin是shi賠pei付fu費fei和he醫yi療liao補bu償chang費fei到dao底di是shi多duo少shao,沒mei有you規gui定ding,我wo個ge人ren理li解jie,應ying該gai按an照zhao平ping均jun壽shou命ming來lai計ji算suan。他ta在zai賠pei付fu費fei按an照zhao醫yi療liao事shi故gu發fa生sheng上shang一yi年nian度du,職zhi工gong平ping均jun工gong資zi計ji算suan。具ju體ti計ji算suan多duo少shao年nian,具ju體ti看kan。
這zhe個ge問wen題ti是shi大da家jia問wen到dao,如ru果guo是shi診zhen療liao係xi統tong,轉zhuan為wei一yi號hao,發fa生sheng醫yi療liao事shi故gu過guo程cheng中zhong的de,我wo個ge人ren觀guan點dian,醫yi療liao部bu門men如ru果guo完wan全quan是shi在zai出chu現xian醫yi療liao事shi故gu之zhi前qian完wan成cheng的de,有you一yi個ge持chi續xu性xing的de情qing況kuang,就jiu應ying該gai之zhi前qian鑒jian定ding,如ru果guo有you一yi個ge持chi續xu性xing的de情qing況kuang,在zai前qian麵mian治zhi療liao的de情qing況kuang下xia,9月1號前麵開始延續到9月1號以後,醫療事故也是在醫療事故責任以後,才發生,這樣的情況可以按照條例規定的過程。
說明具體賠償數額,醫療事故責任,敘述三者之間的關係。我簡單講一下,49條和第50條的關係。按照第50條的規定,計算出來的各種各樣的費用總額,加起來,應該考慮在這樣的基礎上,對49條tiao的de規gui定ding。第di一yi個ge是shi以yi來lai事shi故gu等deng級ji,如ru果guo是shi一yi級ji醫yi療liao事shi故gu,賠pei償chang百bai分fen之zhi百bai。那na麼me同tong時shi還hai要yao考kao慮lv醫yi療liao過guo失shi行xing為wei對dui後hou麵mian的de損sun害hai後hou果guo。如ru果guo是shi醫yi療liao事shi故gu損sun害hai是shi百bai分fen之zhi百bai,賠pei償chang也ye是shi百bai分fen之zhi百bai。醫yi療liao事shi故gu判pan斷duan原yuan有you的de狀zhuang況kuang和he責ze任ren關guan係xi。因yin為wei我wo們men講jiang到dao說shuo,醫yi療liao費fei是shi不bu包bao括kuo原yuan發fa疾ji病bing治zhi療liao費fei。這zhe個ge關guan係xi指zhi的de是shi適shi用yong後hou麵mian一yi些xie情qing況kuang。下xia麵mian一yi個ge問wen題ti是shi如ru果guo準zhun確que認ren定ding患huan者zhe應ying該gai知zhi道dao全quan麵mian侵qin害hai的de時shi間jian,及ji訴su訟song事shi項xiang器qi件jian及ji侵qin害hai時shi間jian。這zhe個ge是shi按an照zhao通tong常chang的de人ren身shen損sun害hai的de賠pei償chang。這zhe種zhong標biao準zhun來lai判pan斷duan,不bu能neng說shuo,以yi患huan者zhe接jie受shou治zhi療liao的de這zhe個ge行xing為wei作zuo為wei判pan斷duan侵qin權quan訴su訟song的de起qi點dian。但dan是shi呢ne,如ru果guo是shi很hen多duo年nian,多duo少shao年nian以yi後hou,20幾年,或者是30年的醫療機構,我想,大家應該有訴訟審判。
我wo覺jiao得de大da部bu分fen的de問wen題ti都dou是shi差cha不bu多duo。第di一yi點dian,我wo作zuo為wei這zhe個ge通tong知zhi的de具ju體ti的de執zhi行xing人ren之zhi一yi,包bao括kuo我wo們men以yi後hou,這zhe樣yang做zuo司si法fa解jie釋shi,我wo可ke能neng也ye是shi作zuo為wei自zi己ji的de工gong作zuo人ren員yuan之zhi一yi,我wo會hui充chong分fen地di把ba大da家jia的de問wen題ti,向xiang我wo們men最zui高gao法fa院yuan領ling導dao反fan映ying。第di二er,我wo今jin天tian所suo介jie紹shao的de情qing況kuang,完wan全quan是shi個ge人ren的de理li解jie,不bu能neng以yi我wo個ge人ren的de理li解jie做zuo實shi踐jian當dang中zhong操cao作zuo的de標biao準zhun。第di三san,我wo非fei常chang感gan謝xie大da家jia提ti這zhe麼me多duo的de問wen題ti。我wo想xiang今jin天tian上shang午wu就jiu到dao這zhe裏li。
非fei典dian的de問wen題ti,大da家jia知zhi道dao我wo們men最zui高gao人ren民min法fa院yuan到dao目mu前qian為wei止zhi,就jiu涉she及ji非fei典dian的de問wen題ti,發fa了le兩liang個ge通tong知zhi,第di一yi個ge是shi民min法fa,第di二er是shi正zheng式shi通tong知zhi,這zhe兩liang個ge通tong知zhi大da家jia都dou知zhi道dao了le,非fei典dian的de問wen題ti涉she及ji到dao四si方fang麵mian的de問wen題ti。民min事shi關guan係xi的de問wen題ti,侵qin權quan的de問wen題ti,還hai是shi民min事shi訴su訟song等deng等deng,與yu我wo們men在zai座zuo的de有you關guan係xi的de就jiu是shi非fei典dian引yin起qi的de人ren身shen損sun害hai賠pei償chang問wen題ti。按an照zhao我wo們men最zui高gao法fa院yuan目mu前qian的de通tong知zhi規gui定ding,凡fan是shi設she計ji非fei典dian的de醫yi療liao賠pei償chang訴su訟song過guo程cheng中zhong,但dan是shi在zai這zhe個ge基ji礎chu上shang不bu受shou理li,以yi後hou還hai要yao受shou理li。對dui這zhe個ge問wen題ti的de爭zheng論lun,就jiu是shi說shuo,這zhe個ge事shi件jian及ji因yin為wei非fei典dian所suo采cai取qu的de防fang治zhi措cuo施shi,有you人ren認ren為wei,這zhe個ge不bu可ke抗kang拒ju,有you人ren認ren為wei,它ta不bu完wan全quan是shi一yi種zhong不bu可ke抗kang拒ju。
就jiu我wo個ge人ren理li解jie,非fei典dian引yin起qi的de醫yi療liao糾jiu紛fen,包bao括kuo兩liang種zhong情qing況kuang,一yi種zhong情qing況kuang是shi醫yi院yuan對dui非fei典dian病bing人ren或huo者zhe是shi疑yi似si病bing人ren,是shi否fou拒ju絕jue,或huo者zhe是shi是shi否fou采cai取qu緊jin急ji處chu置zhi的de措cuo施shi,要yao不bu要yao承cheng擔dan責ze任ren的de問wen題ti。另ling外wai一yi個ge問wen題ti,患huan者zhe或huo者zhe其qi他ta的de救jiu濟ji者zhe在zai醫yi院yuan當dang中zhong,因yin為wei感gan染ran非fei典dian的de情qing況kuang下xia,醫yi院yuan要yao不bu要yao承cheng擔dan責ze任ren。還hai有you一yi個ge問wen題ti是shi,醫yi院yuan在zai治zhi療liao非fei典dian的de過guo程cheng當dang中zhong,造zao成cheng患huan者zhe死si亡wang,要yao不bu要yao承cheng擔dan責ze任ren。我wo的de個ge人ren的de傾qing向xiang是shi,因yin為wei非fei典dian不bu是shi一yi般ban的de情qing況kuang,按an我wo們men正zheng常chang的de情qing況kuang,這zhe是shi一yi個ge突tu發fa事shi件jian,既ji然ran是shi一yi個ge突tu發fa性xing事shi件jian,就jiu不bu能neng按an照zhao通tong常chang的de標biao準zhun來lai判pan斷duan這zhe個ge事shi情qing。也ye就jiu是shi說shuo,不bu能neng按an照zhao民min法fa通tong則ze的de規gui定ding,或huo者zhe是shi醫yi療liao事shi故gu處chu理li條tiao例li的de規gui定ding。
我(wo)個(ge)人(ren)的(de)想(xiang)法(fa),如(ru)果(guo)醫(yi)院(yuan)醫(yi)療(liao)機(ji)構(gou)和(he)醫(yi)務(wu)工(gong)作(zuo)人(ren)員(yuan)在(zai)診(zhen)療(liao)過(guo)程(cheng)當(dang)中(zhong),沒(mei)有(you)任(ren)何(he)過(guo)錯(cuo),也(ye)沒(mei)有(you)任(ren)何(he)違(wei)規(gui),我(wo)想(xiang)這(zhe)個(ge)過(guo)程(cheng)隻(zhi)是(shi)說(shuo),它(ta)完(wan)全(quan)是(shi)它(ta)自(zi)己(ji)主(zhu)觀(guan)的(de)意(yi)圖(tu)。在(zai)這(zhe)樣(yang)的(de)情(qing)況(kuang)下(xia),如(ru)果(guo)他(ta)是(shi)因(yin)為(wei)這(zhe)個(ge)緣(yuan)故(gu),或(huo)者(zhe)是(shi)因(yin)為(wei)其(qi)他(ta)的(de)緣(yuan)故(gu)。其(qi)次(ci)是(shi)患(huan)者(zhe)感(gan)染(ran)非(fei)典(dian),或(huo)者(zhe)是(shi)患(huan)者(zhe)感(gan)染(ran)非(fei)典(dian)以(yi)後(hou)死(si)亡(wang)。有(you)這(zhe)個(ge)規(gui)定(ding)的(de)醫(yi)療(liao)事(shi)故(gu),應(ying)當(dang)有(you)追(zhui)究(jiu)他(ta)的(de)其(qi)他(ta)的(de)責(ze)任(ren)。這(zhe)是(shi)一(yi)方(fang)麵(mian)。
yinweiwomenzaihenduoqingkuangxia,yiyuanjieshoufeidianbingrenbingbushitazijiziyuande,doushizhengfuyaoqiude。namehenduoqingkuangxia,waiguodeyisheng,zhongyideyisheng,tayebeiyiyuanyaoqiuqucanyuzhegefeidianjiuzhidegongzuo。suiranshuotabufuhezhiyedeguiding,bufuhechanggui,bufuhezhenliaoguifan,namewojiaode,jishitashianzhaoweishengbugongbudezhezhongbutongshijianduan,gongbudezhiliangbiaozhun,anzhaotongchangyiwugongzuozheshuosuoyingdangjindejinshenxiaoxinzhuyiyiwu。jishimouxierenganranfeidian,jiushizaifeichangshiqi,yebuyingdangyouyiliaojigouchengdanzeren。
第di二er種zhong情qing況kuang,隻zhi有you在zai醫yi院yuan特te別bie是shi非fei典dian定ding點dian醫yi院yuan對dui非fei典dian病bing人ren,或huo者zhe是shi疑yi似si病bing人ren拒ju絕jue采cai取qu急ji診zhen或huo者zhe是shi其qi他ta的de緊jin急ji處chu理li措cuo施shi,或huo者zhe說shuo,在zai衛wei生sheng部bu有you明ming確que規gui定ding的de情qing況kuang下xia,他ta不bu采cai取qu正zheng式shi的de措cuo施shi,換huan句ju話hua說shuo,他ta不bu作zuo為wei的de情qing況kuang下xia。那na麼me在zai特te定ding的de情qing況kuang下xia,他ta應ying當dang有you適shi當dang的de責ze任ren。
總(zong)之(zhi),一(yi)句(ju)話(hua),非(fei)典(dian)的(de)問(wen)題(ti)不(bu)能(neng)以(yi)通(tong)常(chang)的(de)要(yao)求(qiu)來(lai)要(yao)求(qiu)醫(yi)院(yuan)或(huo)醫(yi)務(wu)工(gong)作(zuo)者(zhe)。因(yin)為(wei)非(fei)典(dian)的(de)問(wen)題(ti)我(wo)們(men)最(zui)高(gao)法(fa)院(yuan)可(ke)能(neng)要(yao)出(chu)台(tai)一(yi)個(ge)文(wen)件(jian)。國(guo)務(wu)院(yuan)已(yi)經(jing)出(chu)台(tai)了(le)一(yi)個(ge)文(wen)件(jian),關(guan)於(yu)非(fei)典(dian)的(de)訴(su)訟(song)案(an)件(jian),已(yi)經(jing)做(zuo)了(le)相(xiang)應(ying)的(de)司(si)法(fa)解(jie)釋(shi),因(yin)為(wei)非(fei)典(dian)引(yin)起(qi)的(de)醫(yi)療(liao)糾(jiu)紛(fen)。
非常感謝大家。 |