《民法典》第1222条(诊疗过错推定)评注  

Comments on Article 1222 of the Civil Code(Presumption of Fault in Diagnosis and Treatment)

作　　者：武亦文[1] Wu Yiwen

机构地区：[1]武汉大学法学院

出　　处：《财经法学》2024年第3期175-192,共18页Law and Economy

基　　金：2022年度国家社科基金重大项目“我国民法评注编纂重大问题研究”(22&ZD205)的阶段性成果。

摘　　要：《民法典》第1222条系对医疗机构存在诊疗过错的法律推定,患者可以通过证明医疗机构存在本条规定的行为,来代替对“未尽到与当时的医疗水平相应的诊疗义务”的证明。在推定医疗机构存在诊疗过错后,诊疗过错的客观举证责任就转移至医疗机构。若医疗机构证明“尽到了与当时的医疗水平相应的诊疗义务”,则可推翻该推定。本条第1项中的“诊疗规范”是该项所指的实质内容,法律、行政法规、规章以及其他规定均为诊疗规范的载体。诊疗规范是指管理、规范和指引疾病诊断、治疗的规范,其载体除了本条列举的法律规定外,还包括国务院卫生主管部门制定的技术标准与操作规范,全国性行业协(学)会制定的标准、规程、规范、制度以及药品说明书。本条第2项、第3项从实体法上讲是对《民法典》第1225条所规定义务的严重违反,从诉讼法上讲则是证明妨碍行为。该两项病历资料的范围与第1225条所称病历资料的范围一致,但仅限定于“与纠纷有关”的病历资料。“隐匿”“拒绝提供”“遗失”“伪造”“篡改”“违法销毁”均有其规范含义,除文义中体现的主体要件、主观要件和行为要件外,适用本条第2项、第3项推定诊疗过错还要满足结果要件及因果关系要件。The Article 1222 of the Civil Code is a legal presumption that the medical institution has diagnosis and treatment fault,and the patient can prove that the medical institution has the behavior stipulated in this article,instead of proving the“failure to fulfill the obligation of diagnosis and treatment corresponding to the level of medical care at that time”.In the presumption of medical institutions have diagnosis and treatment fault,the objective burden of proof for diagnosis and treatment fault is transferred to the medical institution.The presumption can be rebutted if the medical institution proves that it“fulfilled its obligation to provide treatment appropriate to the level of medical care at the time”.The“diagnosis and treatment standard”in item 1 of this article is the substance of the item,and laws,administrative rules,regulations and other provisions are the carrier of the diagnosis and treatment standard.Diagnostic and therapeutic norms refers to the management,standardization and guidance of disease diagnosis,treatment norms,and in addition to the legal provisions listed in this article,the carrier also includes the technical standards and norms formulated by the state council department in charge of health,the standards,protocols,norms,systems and drug instructions formulated by the national industry associations(academic association).Items 2 and 3 of this article are serious violations of the obligations set forth in Article 1225 of the Civil Code in terms of substantive law,and are proof of obstruction in terms of procedural law.The scope of these two items is the same as that of the medical records referred to in Article 1225,but is limited to medical records“related to the dispute”.Concealment,refusal to provide,loss,forgery,falsification and destruction in violation of the law have their own normative meanings,and in addition to the subjective,subjective and behavioral elements embodied in the text,the application of items 2and 3 of the article to presume the diagnosis and treat

关 键 词：医疗侵权 诊疗规范 病历资料 过错推定 

分 类 号：D92[政治法律—法学]