医疗损害责任过错要件证明之困境及其破解  

On the Proof Difficulty and Solution of Fault Elements in Medical Tort Litigation

作　　者：刘小砚[1] 龚瑶[2] LIU Xiaoyan;GONG Yao(Southwest University of Political Science and Law,Chongqing 401120,China;The First Affiliated Hospital of Chongqing Medical University,Chongqing 400000,China)

机构地区：[1]西南政法大学,重庆401120 [2]重庆医科大学附属第一医院,重庆400000

出　　处：《医学与法学》2024年第3期57-62,共6页Medicine and Jurisprudence

基　　金：2024年最高人民检察院检察应用理论研究课题“新类型虚假诉讼甄别、监督与惩治防范机制研究”和四川医事卫生法治研究中心-中国卫生法学会立项资助项目“公共安全视域下暴力伤医法律规制研究”(项目编号:YF22-Q17)的阶段性成果。

摘　　要：司法实务中,大量医疗损害责任之过错要件的证明责任分配存在混乱、医疗“违法违规”认定泛化和机械适用《民法典》第1222条第2款及第3款来推定过错,致对医疗损害责任过错要件的证明面临困境;进一步探究其因,是人类的技术与认知局限无法查明诊疗过错的事实、主观心理状态与客观证据的关联性弱,以及过错事实证明标准不统一而致法官自由裁量权过大,故需在厘清与细化《民法典》第1222条过错推定规则的基础上,建立重大医疗瑕疵规则、强化医疗机构事案解明义务、合理适用证明妨碍规则。In judicial practice,there are a lot of confusion in the distribution of the burden of proof,the generalization of medical"illegal"identification and the mechanical application of article 1222 paragraph 2 and 3 in The Civil Code to presumption of fault,result⁃ing in difficulties in proving the fault elements of medical tort liability.To further explore the reasons,the technical and cognitive limita⁃tions of human beings cannot identify the facts of fault diagnosis and treatment,the weak correlation between subjective mental state and objective evidence,and the inconsistent standards of proof of fault facts lead to excessive discretion of judges.Therefore,it is neces⁃sary to clarify and elaborate the fault presumption rule in Article 1222 of The Civil Code,establish rules on major medical defects,strengthen the obligation of medical institutions to clarify cases,and reasonably apply the rules of proof of obstruction.

关 键 词：医疗侵权 过错要件 证明责任 证明妨碍 

分 类 号：D923[政治法律—民商法学] R-05[政治法律—法学]