职业病诊断举证倒置规则适用的困境与优化--兼评《职业病诊断与鉴定管理办法》第二十八条  

Study on the dilemma and optimization of applying the rule of inversion of proof in the diagnosis of occupational diseases--Comment on article 28 of Administrative Measures for Diagnosis and Verification of Occupational Diseases

作　　者：胡世杰[1] HU Shi-jie(Guangdong Prorince Hospital for Ocupational Disease Prevention and Treatmenut,Guangdong Prorincial Key Laborutory of Occupational Diseuse Prevention and Treatment.Guangchou,Guangdong 510300,China)

机构地区：[1]广东省职业病防治院,广东省职业病防治重点实验室,广东广州510300

出　　处：《中国职业医学》2021年第4期361-365,共5页China Occupational Medicine

基　　金：广东省科学自然基金(2021A1515010081);国家临床重点专科建设项目(2011-09);广东省职业病防治重点实验室(2017B030314152)。

摘　　要：在职业病诊断与鉴定过程中,实行举证责任倒置的规则。举证的目的在于解决工作场所职业病危害因素与职业病的因果关系问题,其实质是后果责任。但在职业病诊断与鉴定实践中,举证责任倒置规则的适用存在较多困境,不敢适用、难以适用,甚至错误适用情形均有发生。满足盖然性是举证责任倒置规则适用的前提;对证据进行关联性判断是规则适用根本途径;对《职业病诊断与鉴定管理办法》第二十八条进行优化,删除其中的前置条件"经卫生健康主管部门督促",是规则准确适用的重要保障。厘清举证责任的本质,在职业病诊断与鉴定实践中正确适用与优化举证规则,进一步完善立法,推动相关法律制度的准确适用,有利于保障劳动者职业健康权益,落实用人单位职业病防治主体责任。In the process of occupational disease diagnosis and verification, the rule of inversion of proof is implemented. The purpose of proof is to solve the causal relationship between occupational hazardous factors and occupational diseases in the workplace, and its essence is the responsibility for consequences. However, in the practice of diagnosis and verification of occupational diseases, there are many difficulties in the application of the rule of inversion of burden of proof, which is dare not apply, difficult to apply, and wrong application might occur. Satisfying probability is the premise for the application of the rule of inversion of burden of proof. The relevant judgment of evidence is the basic way to apply the rule. Optimize the article 28 of Administrative Measures for Diagnosis and Verification of Occupational Diseases, delete the precondition “urged by health authorities”, that is an important guarantee for the accurate application of the rule. To clarify the nature of the burden of proof, correctly apply and optimize the rules of proof in the practice of diagnosis and verification occupational diseases, further improve the legislation, and promote the accurate application of the relevant legal system are conducive to protecting the rights and interests of workers in occupational health and implementing the principal responsibility of employers for occupational disease prevention and control.

关 键 词：职业病 诊断 鉴定 举证责任 规则 因果关系 适用 优化 

分 类 号：R13[医药卫生—劳动卫生]