双重属性视角下江苏医疗损害鉴定新旧两种模式的对比分析及其制度变革再思考  

Comparative analysis of the old and new models of medical damage identification in Jiangsu Province from the perspective of dual attributes and rethinking of its system reform

作　　者：江涛[1,2] 张士成 郑菁 张诗钰 李富 Jiang Tao;Zhang Shicheng;Zheng Jing;Zhang Shiyu;Li Fu(Nanjing Medical Association Office,Nanjing 210003,China;Technical Appraisal Office for Medical Accidents of Nanjing Medical Association,Nanjing 210003,China;Academic Affairs Department of Nanjing Medical Association/Continuing Medical Education Department,Nanjing 210003,China;School of Medical Administration,Nanjing Medical University,Nanjing 211166,China)

机构地区：[1]南京医学会办公室,南京210003 [2]南京医学会医疗事故技术鉴定工作办公室,南京210003 [3]南京医学会学术会务部/继续医学教育部,南京210003 [4]南京医科大学医政学院,南京211166

出　　处：《卫生法学》2024年第5期114-120,126,共8页Health Law

基　　金：2023年南京市医学科技发展专项资金资助项目“南京市医疗纠纷处理和防范体系完善研究”(GAX23301)。

摘　　要：为探讨和比较江苏省医疗损害鉴定制度改革的实际变化与效果,推动领域高质量发展提供依据,采用对比分析和文献分析的方法,对2014年至2021年江苏省内医学会系统和司法鉴定机构的各自典型单中心鉴定数据进行对比分析,从医疗损害纠纷的核心属性视角对制度沿革后的正向效应展开机理阐释。江苏省医疗损害鉴定制度的结构性改造聚焦于鉴定本身的同一性上,主要围绕“谁鉴定”和“谁评判”两个核心因素。通过双轨制模式下“赋予鉴定机构的平等性”和“明确鉴定程序的专业性”两个途径实现医疗损害鉴定的“公正性”和“专业性”,其是推进系统间医疗损害鉴定“趋同演化”的实质。两鉴定系统的“二元对立”逐步走向“双轨协同”,为领域规范改良提供了可行、可靠的“江苏路径”。在新时代多元治理的背景下,医疗损害鉴定体系沿革需要兼顾医疗纠纷中医学与法学的二元属性,“属性合融”的观念是顺应时代体系发展与制度变革初衷,消除或削弱鉴定主体间和程序上的“二元内耗”,才能为化解国内医疗损害纠纷提供有力的科学证据支撑。Objective To explore and compare the actual changes and effects of the reform of medical damage identification and relief system in Jiangsu province,so as to provide a basis for promoting the high-quality development of the field.Methods This paper employs comparative analysis and literature analysis to conduct a comparative analysis of the appraisal data of the Jiangsu Provincial Internal Medicine Association system and judicial appraisal institutions between 2014and 2021.It elucidates the beneficial outcomes of the system's evolution by examining the core attributes of medical damage disputes.Results The structural reform of the medical damage appraisal relief system in Jiangsu Province focused on the identity of the appraisal itself,focusing on the two core factors of"who appraises"and"who judges",and realizing the"fairness"and"professionalism"of medical damage appraisal through the two ways of"giving equality to different appraisal institutions"and"clarifying the professionalism of appraisal procedures"under the dual-track mode,which is the essence of promoting the"convergent evolution"of medical damage appraisal between systems.Conclusion In light of the new era's pluralistic governance,the evolution of medical damage appraisal systems must take into account the dual attributes of medicine and law in medical disputes.The goal of"attribute integration"is to adhere to the original intent of system development and system reform by eliminating or weakening the"dual internal friction"among appraisal subjects and programs in order to provide strong scientific evidence support for resolving domestic medical damage disputes.

关 键 词：医疗损害鉴定 制度变革 双重属性 对比分析 文献分析法 实践思考 

分 类 号：D902[政治法律—法学理论]