医疗纠纷诉讼外解决机制探析

医疗纠纷已成为我国一大社会矛盾,而医疗纠纷的解决也是困扰我国法律界和医疗界的一大难题。目前我国医疗纠纷的解决机制存在很多问题,医疗诉讼成本过高,患者处于弱势地位等等。诉讼方式解决医疗纠纷将医患关系引向不和谐的地步,因此,要解决我国医患冲突,应该在医疗纠纷诉讼外寻求解决途径,完善现有的医疗纠纷调解方式,加强人民调解在处理医疗纠纷当中的效力。拓宽医疗纠纷诉讼外解决机制,是医患双方能够在一个非诉讼的场合理智和谐地解决冲突的一剂良方。     

关于健全医疗纠纷调解处理机制的初探

医疗关系的和谐稳定，与医疗纠纷调解处理机制的健全与否是息息相关的。文章通过对广西玉林市、北海市、崇左市天等县和河池市都安县的实地调研，分别从医疗纠纷调解处理机制现状、存在问题以及展望入手，以点带面，以此期望能够给医疗纠纷调解处理机制的健全作出一定的贡献。     

医疗纠纷多元调解新机制思考与探索

目前我国医疗纠纷逐年增多,成为社会各界普遍关注的热点问题。同时,医疗纠纷解决机制的各种弊病也不断暴露出来,医疗纠纷解决现状令人堪忧。因此,如何克服医疗纠纷各种调解机制的自身缺陷,实现人民调解、行政调解、司法调解三种方式之间的有机衔接具有重要的理论和实践意义。     

我国医疗纠纷的多元化解决机制初探

医患关系的紧张、医疗纠纷的增多,是影响和谐社会建设的不稳定因素。目前我国医疗纠纷的处理机制不够完善,有必要借鉴国外医疗纠纷解决机制的经验,发展多元化的医疗纠纷解决机制,建立医疗纠纷调解、仲裁和保险制度。     

医疗事故，谁来裁决？——医疗事故鉴定相关法律问题研究

医疗纠纷投诉大幅增加、医患双方利益矛盾日益尖锐和复杂,已成为当今社会的热点、难点问题。特别是那些损害后果严重、专业技术复杂、责任难以确定的医疗纠纷,有时会持续很多年,涉及医患双方、卫生行政部门、司法部门以及医疗事故技术鉴定机构等诸多部门和人员,调解和处理起来非常困难。在纠纷处理过程中,最为核心的环节是对医疗事故的鉴定,鉴定结论也因其     

贫困地区医疗纠纷调解现状分析及对策建议——以重庆市黔江区医疗纠纷调解工作为例

医疗纠纷成为近年来社会关注的热点、焦点和难点问题,我国各地正通过成立医调委的形式来推动医疗纠纷的化解.本文以重庆市黔江区医疗纠纷调节现状为例,分析贫困地区医疗纠纷存在的问题及成因,并提出贫困地区医疗纠纷调解的对策建议.     

医疗纠纷行政调解制度的适用困境与建议

行政调解制度成为医疗纠纷的法定解决途径已久，也有着其他途径不可比拟的优势，但由于立法上的不足和实践中的困境，其适用持续受限。为完善医疗纠纷行政调解制度，在立法上应该增强行政调解介入的主动性、设置弹性调解期限、强化调解协议效力、细化调解程序；在实践中应该设立独立的调解机构并优化调解人员配置，使医疗纠纷行政调解制度真正发挥其应有的作用。     

从医疗纠纷处理谈医院的自我保护

医疗纠纷处理与医疗纠纷防范具有同等的重要性。目前,解决困扰医疗机构的医疗纠纷问题,已得到党和国家的重视,新的医疗事故处理办法不久将替代十年以前的医疗事故实施细则。这无疑会给医患双方解决纠纷带来实质性的突破,会使公平、公正、实事求是、依法办事解决医疗纠纷的途径变得畅通。现解决纠纷的三种途径:当事人协商解决,行政调解和人民法院裁定仍将延用,今后会有新的内容和调整侧重点,也会开辟新的途径。本文结合案例,就新时期医疗纠纷处理采取的主要途径及医疗机构寻求法律保护的问题谈几点看法。 1.案例介绍、分析 1.1 案例一女 24岁入院诊断:妊娠40~ 周待产入院后给予各项检查及胎儿监测无特殊情况,于第九天开始自发临产。在正式临产4小时。常规检查发现脐带脱垂,经紧急处理,半小时内在局麻下剖腹娩出一重度窒息的     

医疗纠纷第三方调解的模式分析及构建

面对频繁发生和不断升级的医疗纠纷,我国现有法律规定的解决途径在处理时往往束手无策手,于是在医疗纠纷中引入相对"温和"、有效的"第三方调解"成为时下新宠.目前很多城市和地区也都摸索出了自己的特有模式并取得了显著的成效.然而,随着时间的推移,这些模式所存在的问题也逐渐暴露出来,因此,应当在我国现有成就的基础上,借鉴国外先进...     

美国医疗纠纷解决机制及其启示

正从近年我国医疗纠纷解决方式的发展变化趋势上看,人民调解介入医疗纠纷,通过调解方式预防和化解医疗纠纷发挥着越来越重要的作用1。这种发展趋势同当前世界各国处理医疗纠纷时注重调解方式的运用,在医疗纠纷的解决方式上普遍呈现出逐渐由诉讼外医疗纠纷解决机制2来代替诉讼纠纷解决机制的发     

医疗责任保险的思考

大力发展医疗责任保险,对医疗执业过失给患者造成的损害进行充分赔偿,在保障患者和医疗机构及其医务人员的合法权益,优化医疗环境和医疗公共秩序方面有重要的促进作用。由于我国医院主体是公立医院,侵权法人身损害赔偿相对于综合医院尚未到重大程度,并且综合性医院每年发生的医疗过失案件基本确定,选择满足面临危险的医院财务安全需要的医疗责任保险模式,如医疗责任保险信托等,才能促进医疗责任保险的发展。实践表明,商业性医疗责任保险不宜成为我国医疗责任保险的主体。建立独立的医疗过失纠纷调解鉴定机构,才能保证医疗责任保险顺利开展。     

浅析医疗纠纷案件久拖不决的原因及对策建议

随着我国依法治国方略的不断践行，法制宣传教育的不断深入，公民的法律意识、维权意识在不断提高，医疗纠纷案件也逐年增加。影响案件解决的因素复杂、多样，本文主要从调解解决、司法鉴定环节、法院诉讼几个阶段分析造成医疗纠纷案件久拖不决的原因以及提出相应的对策建议。     

韩国医疗纠纷调解立法及对我国的启示

为有效化解医疗纠纷、救济医疗损害从而为医务人员创造一个安宁的诊疗环境,韩国出台了《关于医疗事故损害救济及医疗纠纷调解等的法律》。依据该法律之规定,韩国设立了医疗纠纷调解仲裁院,在调解仲裁院下设医疗纠纷调解委员会和医疗事故鉴定团,实施新的医疗纠纷调解仲裁制度。该法律还规定了医疗损害赔偿互助制度、医疗损害无过失补偿制度及代偿制度等。     

Interest-based mediation of medical malpractice lawsuits: a route to improved patient safety?

Mediation of medical malpractice lawsuits provides savings for the parties by shortening the litigation process. In theory, information that aids emotional healing and improves patient care can also surface through mediation. The study discussed in this article used structured interviews of participants and mediators in thirty-one mediated malpractice lawsuits involving eleven nonprofit hospitals. The study measured perceptions of the process and mediation's effects on settlement, expenses, apology, satisfaction, and information exchange. Defense lawyers were less likely than plaintiff attorneys to mediate. Both plaintiff and defense attorneys were satisfied with the process, as were plaintiffs, hospital representatives, and insurers. Changes in hospitals' practices or policies to improve patient safety were identified. This study demonstrates that major challenges stand in the way of achieving mediation's full benefits. Absence of physician participation minimizes the chances that mediated discussion of adverse events and medical errors can lead to improved quality of care. Change will require medical leaders, hospital administrators, and malpractice insurers to temper their suspicion of the tort system sufficiently to approach medical errors and adverse events as learning opportunities, and to retain lawyers who embrace mediation as an opportunity to solve problems, show compassion, and improve care.     

论医疗注意义务与医疗过失的认定

无论基于医疗契约还是医疗侵权关系，医疗过失的认定标准、考量因素、考察范围都趋于一致。应确定相对客观的医疗过失判定标准，在具体考量时还应兼顾医疗水准等诸多主客观因素。应立足于医院作为医疗损害赔偿责任的“一元”主体，分别从医疗行为和医疗辅助行为去查找医疗过失。审判实务中对医疗过失的认定过分依赖鉴定的流弊应当予以矫正，而应将医疗过失的认定权回归法庭，并辅之以组建专业审判庭、引入专家证人制度作为法庭认定医疗过失的专业保障。     

论强制性医疗损害赔偿保险制度的建立

通过对我国医疗损害赔偿给付现状的分析,对国外医疗责任保险及给付的比较,认为:只有通过立法来建立一种强制医疗损害赔偿保险制度才能较合理地解决医疗损害受害人损害赔偿的兑现问题,同时,又不使医疗法人的正常医疗行为因此受到影响;并进一步指出了建立该种保险制度所存在的问题和对策。     

Patient Compensation Funds: legislative responses to the medical malpractice crisis

Fifteen states have created Patient Compensation Funds in response to the increased cost and reduced availability of medical malpractice insurance associated with the so-called "medical malpractice crisis." Patient Compensation Fund statutes limit health care providers' liability to a specified amount, and establish state-administered funds to compensate victorious malpractice plaintiffs for damage awards in excess of that amount. This Note examines the Patient Compensation Fund mechanism, evaluates its effectiveness as a compensation system for malpractice victims, and recommends particular provisions that might enhance its effectiveness. The Note concludes that the Patient Compensation Fund mechanism is an effective means of increasing the availability and of reducing the cost of medical malpractice insurance, and should be adopted by other states experiencing a "medical malpractice crisis."     

Medical malpractice as reflected by the forensic evaluation of 4450 autopsies

A multicentre retrospective analysis of 4450 autopsies carried out due to suspicion of medical malpractice in 17 German institutes of forensic medicine from 1990 to 2000 was performed for the German Federal Ministry of Health. During the time period analysed an increase of cases could be mentioned. The main results of the study are: in the cooperating institutes the total number of autopsies due to suspected medical malpractice ranged from 1.4 to 20%. In more than 40% of the cases preliminary proceedings were started because the manner of death was certified as non-natural or not clarified. Hospital doctors were more affected by medical malpractice claims than doctors in private practice. However, the number of confirmed cases of medical malpractice was higher for doctors in private practice than for hospital doctors. Although surgery is still at the top of the disciplines involved in medical malpractice claims the number of confirmed surgical cases was below the average. Mistakes in care were confirmed to be above the average. Medico-legal autopsies are still a very sufficient method to evaluate cases of medical malpractice: 2863 cases could already be clarified by autopsy. Up to now there is no systematic registration of medical malpractice charges in Germany. A systematic registration should be initiated to build up and/or improve error reporting systems and, thus, to improve patient safety. Compared to other sources of medical malpractice claims (arbitration committees of the medical chambers, reference material of health and insurance companies, files of civil courts) the data of the present multicentre study are in so far unique as only lethal cases were evaluated and a complete autopsy report was available as basis of an expert opinion in alleged medical malpractice cases.     

论医疗纠纷诉讼中的证据协力义务

由于医疗活动的高度专业性，因而在医疗纠纷诉讼中存在证据偏在、医患武器不平等严重问题。证据协力义务是居于“准确”、“公正”、“和谐”、“效率”等的价值基础。共在医疗纠纷诉讼中的适用具有正当性。建议通过医疗机构的阐明病历义务，对证人、鉴定人违反证据协力义务的制裁，证人拒绝提供证言权等规范来弥补医疗纠纷诉讼中证据协力义务的结构性缺失，以增加医疗纠纷诉讼中证据协力义务规范的可预测性。     

威慑与矫正--论法律对医疗事故的预防作用

医疗事故应当"以防为主".法律对医疗事故的预防作用主要有两条思路一是传统的过错责任体系,强调对于个别医生的威慑,促使其提高注意力标准从而避免医疗事故;二是正在研究的"无过错补偿制度",其关注的是整个医疗行业,试图矫正现行的医疗体制,利用制度的记忆来避免医疗事故的发生.由于无过错责任真正从根源上探寻医疗事故的原因,所以它将是有效的预防措施.但是要实现无过错机制的预防功能,必须建构起相应的配套制度,从而从根本上降低医疗事故的发生率.