论职业病诊断的医学循证与法律推定

不同于一般临床疾病的诊断,职业病诊断是归因诊断,兼具医学性、法律性的特点。《职业病防治法》第四十六条前两款对职业病诊断作出了原则性规定,其中第二款的法律推定体现了职业病诊断的立法价值取向。然而,职业病诊断标准并未高度契合法律推定条款,法律推定操作性欠佳,诊断实务中不同专家对这两款的各自作用和相互关系认识不一,法律推定的适用与否直接影响诊断结论和法律价值的个案实现。对职业病诊断中该两款的协调及法律推定的操作进行论述,以供参考。

Discussion on the medical evidence-based and legal presumption of occupational disease diagnosis

Unlike the diagnosis of general clinical diseases,occupational disease diagnosis is attribution diagnosis,which has both medical and legal characteristics.The first two paragraph of Article 46 of The Occupational Disease Prevention and Control Law of the People’s Republic of China stipulate in principle the diagnosis of occupational diseases.The legal presumption of the second paragraph reflects the legislative value orientation of the diagnosis of occupational diseases.However,the diagnostic criteria for occupational diseases do not fully conform to the provisions of presumption of law.The operability of presumption of law is not good.In diagnostic practice,different experts have different understandings of the respective roles and relationships of these two sections.The application of presumption of law directly affects the realization of diagnostic conclusions and legal values in individual cases.This paper discussed the coordination of the two sections and the operation of legal presumption in the diagnosis of occupational diseases for reference.