乡村医生涉诉医疗损害纠纷实证分析与对策研究  

Empirical Analysis and Countermeasure Research on Medical Injury Disputes Relating Rural Doctors

作　　者：林彬 袁戎 王珊珊[2] 覃静茹 张晨韵 Lin Bin;Yuan Rong;Wang Shanshan;Tan Jingru;Zhang Chenyun(School of Public Health,Fujian Medical University,Fuzhou 350122,China;School of Health Management,Fujian Medical University,Fuzhou 350122,China)

机构地区：[1]福建医科大学公共卫生学院,福州350122 [2]福建医科大学卫生管理学院,福州350122

出　　处：《卫生法学》2025年第2期22-28,75,共8页Health Law

基　　金：福建省科协一流学会建设项目-福建省医药卫生体制改革研究会(FJKX-2022XYL009);福建省医药卫生体制改革研究会2023年度卫生健康政策创新研究项目“基于审判视角的乡村医生致医疗损害研究”(2023B03)。

摘　　要：目的:分析乡村医生因违反诊疗法律法规、常规而导致的医疗损害案件中的焦点争议,提示其在执业过程中潜在的过错及法律风险,并就防范措施提出对策建议。方法:检索“中国裁判文书网”全网,对相关案例中涉及乡村医生执业的过错行为、法律风险等有效信息进行提取、归纳。结果:纳入本次研究分析的判决书共433份。其中367件案例判定乡村医生存在过错应赔偿患方。除43例裁判文书未明确表述医方的过错原因外,大部分案例中乡村医生的行医过程都涉及多方面过错:74件案例存在超范围执业的情形,245件存在不同程度的诊疗措施不当,部分案例还提示证据方面的问题。结论:尽管基层卫生机构及其人员在技术水平、客观条件方面存在诸多限制,但乡村医生自身医疗过错才是承担赔偿责任的主因。应结合乡村医生执业特点、易发医疗纠纷领域等因素,从主体、行为、证据等各方面规范乡村医生从业,以减少医疗损害案件的发生。Objective:To analyze the key points in medical damage cases caused by rural doctors'violation of health laws,regulations and routines,remind them of potential mistakes and legal risks in the process of practice,and put forward countermeasures and suggestions for preventive measures.Methods:Search China Judgments Online and summarize effective information such as wrongdoing and legal risks relating rural doctors'practice.Results:A total of 433 judgments were included in the analysis of this study.Among them,367 cases indicated that the rural doctors were at fault and should compensate the patients.In addition to 43 cases in which the judgment documents did not clearly state the reasons for the doctors'fault,the medical practice by rural doctors involved multiple faults in most cases:74 cases involved treatments beyond the scope of medical practice,245 cases had improper diagnosis and treatment measures to varying degrees,and some cases also suggested problems with evidence.Conclusion:Although there are many restrictions on the technical level and objective conditions of primary health institutions,the medical fault of rural doctors themselves is the main reason for liability.Factors such as the characteristics of village doctors'practice and the areas prone to medical disputes should be combined to standardize the practice of rural doctors from various aspects such as subjects,behaviors,and evidence,so as to reduce the occurrence of medical damage cases.

关 键 词：乡村医生 医疗损害 医疗过错 

分 类 号：D922.16[政治法律—宪法学与行政法学]