循证医学证据首次直接用于医疗及其侵权诉讼引发的问题与思考  

Problems and Thoughts Caused by the First Direct Use of Cochrane Reviews in Medicine and Medical Lawsuit

作　　者：宋儒亮[1] 

机构地区：[1]法治广东研究中心,广东省委党校,广东行政学院

出　　处：《循证医学》2014年第4期244-256,共13页The Journal of Evidence-Based Medicine

摘　　要：国外Cochrane系统评价是一种典型的循证医学证据。本文以具代表性的国外Cochrane系统评价为例,就循证医学证据在国内首次直接用于医疗及侵权诉讼时,面临诸如是否属于民事诉讼证据、属于哪类民事诉讼证据以及能否直接被法院采纳等争议进行研究和分析。同时,就如何处理Cochrane系统评价的变化性与法律证据的稳定性的矛盾、循证医学的新旧证据冲突、Cochrane系统评价适用本土化争议、循证医学证据对包括教科书等在内既有医学理念与结论之冲击、三者(循证医学证据、患者意愿和医师经验)该如何选择与取舍、国外循证医学证据在中国医疗及医疗侵权首次适用面临的医法转化困境以及循证医学证据的司法化等问题进行医法结合性论述。循证医学证据在医疗及医疗侵权类诉讼中的选择和运用是循证医学证据具有生命力的又一明证。Cochrane review is a typical evidence-based medical evidence in other countries. In this paper, the representative Cochrane systematic reviews will be cited as examples to study and analyze the controversy that is generated in the process of Cochrane systematic reviews which are first used directly in medicine and medical lawsuit.The controversy includes dispute whether it is evidence in civil proceedings, belongs to what kind of evidence in civil proceedings and whether it is directly adopted by the court and so on. Meanwhile, contradictions between Cochrane review of change and stability of legal evidence, conflicts between new evidence-based medicine and old, disputesabout if the evidence-based medicine is suitable for use in China, evidence-based medicine＇s impact on existing medical concepts that are included in textbooks, how to select and choose in evidence-based medicine, the wishes of patient and doctor＇s experience, the dilemma of transformation between medicine and law produced in the process of foreign evidence-based medicine first used in China medical and medical tort, evidence-based medical evidence being judicial, all the questions mentioned above will be analyzed in the way of combination of medicine and law. The selection and using of evidence-based medicine in medical tort lawsuit is another proof of the evidence-based medicine with vitality.

关 键 词：证据 循证医学 医疗诉讼 COCHRANE系统评价 

分 类 号：R-03[医药卫生] D925.1[政治法律—诉讼法学]