医疗行为中的患者承诺研究

医疗行为中的患者承诺不是一种对利益的处分与放弃,而是一种对医疗风险的分担,其体现了“被允许的危险”理论与“危险分配”的法理;患者承诺的有效要件包括认识能力与真实意思两个方面;未经患者承诺的医疗行为是专断的医疗行为,应根据医疗效果是否最终实现分别进行处理。     

医疗过失犯的限缩——以注意义务阻却事由为视角

医疗过失的本质在于对医疗注意义务的违反。注意义务阻却事由主要包括被允许的危险和信赖原则。鉴于医疗行为较之其他业务行为具有更高的风险性,因而更有必要在医疗过失犯的认定中适用注意义务阻却事由。在对医疗危险进行合理分配的基础上,被允许的危险和信赖原则通过对行为人注意义务的否定,阻却了行为人的过失责任。从价值理念来说,体现了刑法的谦抑性;从适用效果来看,就是医疗过失犯的限缩。     

医疗过失犯的限缩——以注意义务阻却事由为视角

医疗过失的本质在于对医疗注意义务的违反。注意义务阻却事由主要包括被允许的危险和信赖原则。鉴于医疗行为较之其他业务行为具有更高的风险性，因而更有必要在医疗过失犯的认定中适用注意义务阻却事由。在对医疗危险进行合理分配的基础上，被允许的危险和信赖原则通过对行为人注意义务的否定，阻却了行为人的过失责任。从价值理念来说，体现了刑法的谦抑性；从适用效果来看，就是医疗过失犯的限缩。     

论医疗过失刑事责任成立范围的限定

医疗行为较之于其他业务行为具有更高的风险性。如果让医务人员对所发生的任何损害结果都承担刑事责任的话,必然不利于医疗行为的完成。为此,有必要通过被允许的危险理论和信赖原则对医疗过失刑事责任的成立范围进行限定,减轻医务人员刑事责任过重的负担,这对于患者的利益维护及医学的进步有着极为重要的意义。     

从刑法理论看医疗行为的正当性根据

医疗行为从表面看似乎给人体造成一定伤害,但其主观目的在于治病救人, 客观上有利于患者和社会,因此具有正当性.但医疗行为的正当性具有严格的条件限制.本文根据允许的危险、受害人承诺、义务冲突等刑法理论,对医疗行为的正当性根据作了进一步探讨.     

从刑法理论看医疗行为的正当性根据

医疗行为从表面看似乎给人体造成一定伤害 ,但其主观目的在于治病救人 ,客观上有利于患者和社会 ,因此具有正当性。但医疗行为的正当性具有严格的条件限制。本文根据允许的危险、受害人承诺、义务冲突等刑法理论 ,对医疗行为的正当性根据作了进一步探讨。     

论偶然防卫

讨论偶然防卫具有重要的理论价值；行为无价值论的既遂说,实际上是主观主义的观点,理由存在缺陷；行为无价值论的未遂说,出现了“偶然防卫虽然违法但在行为当时必须允许”、“偶然防卫在行为当时应当允许但事后应当受到处罚”等诸多无法克服的矛盾现象,并不可取；结果无价值论的未遂论,忽视了偶然防卫的危险判断与一般故意行为的危险判断的区分,结论存在疑问；结果无价值论的二分说,得出了偶然防卫者的法益因为缺乏防卫意识而丧失的不当结论,并不可采；结果无价值论(防卫意识不要说)的无罪说,首尾一贯、结论妥当、根据充分.     

紧急避险法律性质研究

紧急避险是合法利益之间的冲突,其之所以被允许,是因为没有引起成立犯罪程度的法益侵害.这是判断行为是否成立紧急避险的出发点.从此立场出发,可以得出以下结论:对生命的紧急避险,从犯罪的本质是值得刑罚处罚程度的法益侵害的角度来看,未尝不可,只是在其适用上,必须严格限定;对自招危险的紧急避险,原则上不予允许,行为人具有忍受义务;只有所遭受的侵害超出了应当忍受的限度时,才能允许.     

风险社会下抽象危险犯的理论境域

"风险社会"催生了所谓的"风险刑法",而"风险刑法"的核心内容就是抽象危险犯。抽象危险犯对具有危险性的行为进行的一般性禁止是行为无价值的表现,对刑法规范效力的维护确实有积极的价值。虽然抽象危险犯背离了以结果无价值为基础的法益理论,但抽象危险犯是法益保护前置化的措施,是基于更为周延保护法益的考虑。此外,抽象危险犯在结果发生之前对行为进行规制,也暗合了刑法的积极一般预防理论。     

推定的被害人承诺问题研究

实在的被害人承诺和推定的被害人承诺的本质区别即现实的承诺行为是否存在。学界关于推定承诺的正当化依据有紧急避险说、无因管理说、允许危险说等学说。推定承诺有为被害人利益和为他人利益的推定承诺之分。推定承诺的有效要件主要包括:共同性要件、补充性情形、为被害人利益意思、行为所造成损害具有社会的相当性。     

医疗过失简论

传统过失犯理论(旧过失论)实质是以“结果无价值论”为其理论基础的。对医疗过失的认定方式无异于对医务人员课以事实上的绝对责任,不利于医学的发展及社会生活的进步。以容许危险理论为基础的新过失论,不仅重视结果无价值,更引入了行为无价值,从而缓和了过失犯的成立,对医疗事故的责任认定方式具有指导意义。     

Patient information on drug therapy. A problem of medical malpractice law: between product safety and user safety

Medicinal products are associated with risks as well as potential therapeutic benefits. This is reflected by the legal requirements for patient information on drug therapy which can be differentiated into general product information, regulated by pharmaceutical (i. e. product safety) law, and individual patient information on the treatment with the product, which is subject to medical malpractice law. The physician's duty to inform the patient comprises therapeutic information as well as information required for informed consent. Therapeutic information intends to empower the patient to comply with the requirements of treatment and to protect him/her against preventable danger and risk; it is part of the medical treatment, aimed at the individual patient and his/her personal situation. Information required for informed consent enables the patient to a self-determined decision on the treatment offered; it can be divided into information on the course of treatment and risk information. Product information and treatment information complement each other; the former should be the basis of individual information on the concrete treatment, provided by the physician in a mandatory oral conversation with the patient. Product information cannot replace the physician's individual information about the treatment.     

行为功利主义违法观

刑法绝对排斥对正当行为的处罚;评价行为正当与否,应当以行为功利主义为原则,因而应当采取结果无价值论;在两种法益存在冲突的情况下,应当通过法益的衡量判断行为正当与否;符合构成要件的行为,即使违反了某种规则,但只要保护了更为优越或者同等的法益,就应成为正当化事由;行为正当与否与行为人应否受谴责不是同一个问题,因此,刑法理论必须严格区分违法与有责。     

精神障碍患者约束和隔离措施的法律规制

约束和隔离是严重剥夺精神障碍患者人身自由的强制措施。约束和隔离实施中所存在的非人道性、危险性和负面效果使得该措施饱受争议,因而法律只允许在例外情况下使用约束和隔离措施,并对其实施条件和程序予以严格限制。即,在实体上明确约束和隔离措施的适用条件和情形,在程序上明确约束和隔离措施的实施步骤,从而构筑起约束、隔离的法律规制体系。     

Treatment Decisions for Critically Ill Infants: The Abrogation of the Best Interests Standard

The issue of withholding or withdrawing medical treatment from seriously ill newborns first gained the attention of the American public in 1982 when Baby Doe was allowed to die without surgery. Since that time, the predominant ethical, medical, and legal approach has been one that allows informed parents to make a reasonable medical treatment decision in the best interests of their infant with the concurrence of the health care providers. There has always been a minority that believes every infant should receive full medical treatment without regard to pain and suffering, until that infant dies a natural death. This viewpoint is reflected in recent judicial and legislative proceedings that have either already drastically changed the prevailing standard of care or threaten do so. This article reviews the significance of these changes.     

妨害传染病防治罪的几个构成要件问题

妨害传染病防治罪的客体应当表述为"国家对传染病防治的管理制度";其客观要件"引起甲类传染病传播或者有传播严重危险"包括实害犯与危险犯两种形态;其主观要件应为过失,故意则不能构成。     

论注意义务阻却事由

注意义务阻却事由主要包括被允许的危险和信赖原则，它是传统过失犯理论适应发展变化的现实生活需要的必然结果，具有缩小过失责任的功能。从国外的情况看，被允许的危险和信赖原则经由判例逐步占据稳固地位，现被广泛适用。在我国，注意义务阻却事由的地位还没有得到形式上的肯定。但事实上，它在我国社会生活的各个领域正发挥着作用。被允许的危险和信赖原则应当在我国的刑法理论中有所体现。     

Limits of guardian treatment refusal: a reasonableness standard

The debate concerning the legal and ethical bases of guardian refusal of medical treatment on behalf of incompetent patients often ignores critical distinctions among types of patients and guardians. For example, patients who have expressed preferences regarding treatment while competent are distinguishable from patients who have always lacked the competency requisite to expressing a treatment preference. "Bonded guardians," whose relationship with the patient preexisted guardianship, should have a different role in the decision-making process than "non-bonded guardians," who were strangers to the patient prior to the guardian-ward relationship. This Article proposes criteria for guardian treatment refusal on behalf of incompetent patients. Under the model for guardian decision making presented here, bonded guardians should be preferred over non-bonded guardians, and bonded guardians should be allowed discretion to make treatment choices, limited only by a standard of reasonableness policed by the courts. The Author presents legal and ethical justifications for the bonded guardian's heightened role. Finally, he considers the proper roles of health professionals, hospital ethics committees, and judges in the decision-making process.