刍议医疗纠纷“妥善处理”的语义内涵及其实践挑战——基于结构语义学与政策范式视角  

On the semantic connotation and practical challenges of“properly handling”medical disputes——From the perspective of structural semantics and policy paradigm

作　　者：张士成 朱之光 江涛[1] 郑菁 李富 Zhang Shicheng;Zhu Zhiguang;Jiang Tao;Zheng Jing;Li Fu(Nanjing Medical Association,,Nanjing 210003,China;School of Medical Administration of Nanjing Medical University,Nanjing 211166,China)

机构地区：[1]南京医学会,南京210003 [2]南京医科大学医政学院,南京211166

出　　处：《卫生法学》2025年第2期29-35,共7页Health Law

基　　金：2023年度南京市卫生科技发展专项资金项目“南京市医疗纠纷处理和防范体系完善研究”(GAX23301)。

摘　　要：目的:明晰医疗纠纷妥善处理的语义内涵及其实践挑战,为领域发展提供话语解释与思路指引。方法:采用结构语义学和政策范式的方法对医疗纠纷“妥善处理”的词义进行概念辨析与理论内涵阐释,并从司法实践的“情理法”情境解释其处理的“妥善”程度要义与存在的现实挑战。结果:在理论层面,基于妥善处理的理性意义和政策文本的话语情境,医疗纠纷的处理需要符合处置时效、“理法”规范、行为道德三要素并解决了纠纷,即可认为解纷处置得到了妥善处理。而在实践层面,医疗纠纷案件处理除了需要契合“理法”的正确性与合理性外,还需医患双方在处置过程、结果中产生“情理”共鸣,达到“情理法”的有效融通,才能实现现实意义上的妥善处理。结论:司法实践范式的要求为医疗纠纷妥善处理带来了巨大挑战,需要领域在纷繁复杂的纠纷因素中进行解纷经验总结、路径方式创新及制度调整优化等治理优劣势实践积累,探索构建“情理法”融合的医疗解纷模式,从而妥善化解医患主体间的矛盾、保障医疗秩序的和谐发展。Objective:To clarify the semantic connotation and practical challenges of dealing with medical disputes properly,as well as to provide discourse explanation and guidance for the field's future development.Methods:Using structural semantics and the policy paradigm,the concept and theoretical connotation of“proper handling”of medical disputes were analysed,and the essence of“proper handling”and the existing practical challenges were explained in the context of“reason,law,and sentiment”in judicial practice.Results:On the theoretical level,based on the rational significance of proper handling and the discourse situation of the policy text,the handling of medical disputes must conform to the three elements of prescription,legal norms,and behavioural ethics,and the dispute is resolved,indicating that the dispute settlement has been properly handled.On a practical level,the handling of medical dispute cases must adhere to the correctness and rationality of“reason and law”,while also ensuring that both doctors and patients resonate with“reason and sentiment”in the handling process and outcomes,in order to achieve effective integration of“reason,law,and sentiment”and proper handling in the practical sense.Conclusion:The requirement of the judicial practice paradigm has posed significant challenges to the proper resolution of medical disputes.It is necessary for the field to summarise the experience of dispute resolution,innovate the path and optimise the system adjustment,and investigate the construction of a medical dispute resolution model with the integration of“reason,law,and sentiment”in order to properly resolve the contradictions between doctors and patients and ensure the harmonious development of medical order.

关 键 词：医疗纠纷 妥善处理 结构语义学 政策范式 理论内涵 实践挑战 

分 类 号：D902[政治法律—法学理论]