论医疗知情同意书——兼评《侵权责任法》第55条、第56条的规定

医疗知情同意书是在施行医疗行为之前充分告知患方相关医疗信息,征得患方同意后与其签订的医疗文书;医疗知情同意书是医方履行告知说明义务、患方行使知情同意权和承担医疗风险的证明文件;它具有督促和证明医方履行告知说明义务、患方行使知情同意权的作用。在某些特殊情形下,基于对患者生命健康权的保护以及对社会公共利益的考量,医方可以排除适用医疗知情同意书;在立法上进一步完善我国的医疗知情同意书制度,对减少和防范因医疗知情同意书而发生的纠纷,对建构和谐的医患关系具有重要的现实意义。     

医患纠纷处理对策

本文从医患纠纷类别、法律关系、医患纠纷现状来分析医患纠纷产生的各方面原因,并进行全面分析,医疗纠纷的发生虽然存在医方原因、患方原因、社会原因等众多原因,作为现行的政府和医疗单位如何减少医疗纠纷,避免医疗纠纷产生不好影响还是能找出规律性的东西,然后实施.最终实现和谐社会关系下的医患和谐之目的.     

让医疗公证健康成长

医疗公证，作为公证领域出现的新生事物，笔者愿意将其定义为：公证机关根据医方或患方的申请，为划清医患双方的风险与责任，以避免不必要的医患纠纷，依照法定程序，对其法律行为、事件或有法律意义的文书，证明其真实性、合法性和可行性的一种非诉讼活动。     

论医疗合同关系

医患法律关系是医事法规在调整医方与患方之间的关系中所形成的权利义务关系。其中医疗合同关系是一种不同于一般合同的特殊民事法律关系。本文以民法的基本理论为依据,结合我国现实情况,力求通过对医疗合同的性质、订立、主体、合同效力等方面的问题进行研究,阐明医患双方当事人各自所应承担的法律责任,归纳出更为公正、合理的解决医患纠纷的对策和理论依据。     

市场经济条件下医疗纠纷防范之对策

医疗纠纷是因医务人员的医疗行为造成患者损害或提供的医疗服务没有达到其预期的要求而产生的医患矛盾。市场经济条件下,对于医疗纠纷需要从医方、患方、社会和法律法规等多方面进行防范。其中医方在医疗纠纷的解决中处于主导地位;患者应当了解医疗行为的高风险性,积极配合治疗;社会有关部门应密切配合,有效地化解和减少医疗纠纷的发生;在法律、法规方面采取相应的措施是有效解决医疗纠纷的关键。     

医疗损害赔偿法律适用的探讨

在医疗损害责任纳入《侵权责任法》的基础上,提出了医患纠纷分为医疗纠纷和非医疗纠纷两大类,医疗纠纷和非医疗纠纷各有四种具体情况。从法律适用的角度,探讨了各种医患纠纷类型赔偿的法律依据;强调了医疗损害责任的归责是过错责任;医疗损害赔偿应根据医方的过错程度予以确定。     

医疗事故责任案中的民事抗辩实务

近年来,因医疗事故而引发的医患纠纷不断增多,由此产生的诉讼案也呈上升趋势.在一些纠纷和诉讼案中,我们不但要认真思考,去分清责任,保护患方的人身健康权不受非法侵害,也要注意研究其中重要的民事抗辩事实与理由,维护医方的合法权益和医疗秩序。本文就医疗事故责任案中的民事抗辩实务作一般论述。医疗事故责任案件的民事抗辩,是指在医疗事故责任案中的医方被告,针对患方原告的诉讼请求,而提出的能够证明患方原告的诉讼请求不成立或不完全成立的事实和理由,继而确定医方被告的责任,达到减责或免责的目的。这种民事抗辩具有两大特点,强烈的对抗性和明确的客观性。强烈的对抗性就是对抗息方原告的诉讼请求权,医方被告依法提出事实与理由而导致患方原告的诉讼请求在法律上不成立或     

论医疗合同关系

医患法律关系是医事法规在调整医方与患方之间的关系中所形成的权利义务关系.其中医疗合同关系是一种不同于一般合同的特殊的民事法律关系.以民法的基本理论为依据,结合我国现实情况,力求通过对医疗合同的成立、性质、特征、主体、合同效力及其终止等方面的问题进行研究,阐明医患双方当事人各自所应承担的法律责任,归纳出更为公正、合理的解决医患纠纷的对策和理论依据,以服务于建设社会主义法治国家的需要.     

论医疗赔偿纠纷法律诉讼适用类型及应对方法

因医患纠纷引起的司法诉讼已成为我国当前调整医患矛盾的主要渠道和手段。而在医疗赔偿的诉讼中，患方提起的诉求已形成“侵权之诉”、“违约之诉”两大诉求并存的局面，同时“侵权之诉”亦由“医疗事故”诉由向“人身损害”诉由转变及数量激增，加大了医方法律诉讼成本及经济赔偿数额。本文分析了我国当前最多见的医疗赔偿纠纷两大诉求与适用法律的类型，以及各种诉求原理对医患双方诉讼的利与弊，提出了“认真应诉、以退为进、据理据实、层层设防、灵活善变”的应诉策略。     

医疗损害举证责任之缓和规则

医疗损害举证责任缓和是指在诉讼中患方的举证达到一定的程度,无法达到法律要求的证明标准情况下,实行举证责任转换,由医方承担举证责任的一种举证责任规则。它是一种不同于举证责任倒置的,有效平衡医患双方当事人在诉讼中举证能力的,充分体现诉讼武器平等原则的举证责任制度。在患方的证明具有相当程度因果关系的可能性、医方无法证明医疗行为与损害结果之间没有因果关系及具备对此种因果关系推定的基础性条件的情况下,才能适用医疗损害举证责任缓和规则。在我国现行立法规定的举证责任规则不能完全保护患方权益的情况下,为了提高诉讼效率,公正、合理地裁判医疗损害纠纷案件,有必要在法律上引入和构建举证责任缓和规则。     

Altruism and Self Interest in Medical Decision Making

We seem to prefer that medicine and medical care be provided through altruistic motives. Even the pharmaceutical industry justifies its behavior in terms of altruistic purposes. But economists have known since Adam Smith that self-interested behavior can create large and growing social benefits. This is true for medical care as well as for other goods. First, I consider specifically the case of pharmaceutical promotion, both to physicians and to consumers. I argue that such promotion is highly beneficial to patients and leads to health improvements. I consider some criticisms of promotion, and show that they are misguided. I then provide some evolutionary explanations for our erroneous beliefs about medical care.     

医-患双方关系与医-患-社保三方关系——由深圳市社保局“钓鱼执法”引发的思考

我国已进入了医-患-社保三方关系的社会本位时代,但人们的思维意识、行为习惯还依然停留在医-患双方关系的个人本位时代。近年来社保定点医疗机构多发不规范医疗行为,甚至与参保患者不谋而合联手“作局”侵害社保利益也屡见不鲜。定点医疗机构与参保患者趋利内核中蕴藏的是强烈的自私利己之人性欲望本能,他们无视了一点：不能只享受社保带来的巨大好处而拒绝维护社保利益。因此,深圳市社保局处理违规定点医疗机构不但完全于法有据而且合理正当甚至难能可贵。但仅此是远远不够的,我们需要更彻底的观念更新及更深刻的制度变革。     

Medicalization and social justice

Most social justice critiques of medical care focus upon the allocation of extant, but scarce, resources. In contrast to that focus, this article explores the preallocative arena of factors which shape the supply and availability of medical care. We identify four such factors: (1)medicalization — the tendency to regard as biologically caused various human problems which were in earlier eras ignored or attributed to other causes; (2)social inclusion — the bringing of economically deprived and socially marginal groups into participation in the medical care system; (3)biomedical transcendence — the elevation of biomedically derived concepts of human function into a social and personal world view; and (4)health absolutism — the ideology which holds individuals accountable for their own health and which, contrary to the thrust of the other factors, deemphasizes access and social equity for professionally provided medical care. While these forces all enhance the place of health as a social value, it is by no means certain that they will lead to a society which is more medically just. The article concludes with an appeal for critical analysis of the processes which shape both the medical care system and the broad social concern with medical care.     

论医疗合同关系

医疗合同关系是以医患双方权利义务为根本内容的重要社会关系。随着科技水平的提高和人们对于自身认识的进步,医院（医生）与患者的关系日益密切,同时医疗纠纷也称层出不穷。而我国目前的法律对于医疗合同关系的调整却很不完善,亟待法律的规范。     

医师专家责任的新视点--兼从医学的角度出发

医疗纠纷是我国近年来的一个社会热点问题,突出表现为医患关系日趋紧张。确定医师的专家责任是解决医疗纠纷的关键,但这是个非常复杂的问题,不仅涉法律知识,而且涉及相关的医学知识。兼从医学角度出发来分析医师的专家责任,可寻求更准确地认定医师的专家责任,使患者的合法权益保护与医学技术发展得以平衡。     

医疗意外损害赔偿中的国家责任

现代科技发展使大量新的技术和产品在医疗诊治中广泛运用,各种潜在的危险因素致使医疗意外损害发生的机率大幅上升,在不可归结于医师和患者等方面的原因而造成对患者合法权益损害的情况下,同样要得到相应利益的补偿才合乎社会的公平和正义。故社会必须建立一种能合理而迅速地分配责任风险、消化损害的国家补偿机制,以实现对被害人的权益保障。     

Is medical care different? Old questions, new answers

This paper examines whether changes in medical markets may be making them more like other markets. The emergence of HMOs and other managed care systems appears to have increased the consumer's potential ability to make better comparative judgments about the price and quality of medical care, and also seems to have made medical care more like other goods. However, the evidence that medical care is a "reputation good" suggests that it is, in this respect, different from other goods. Finally, the social concerns about medical care use necessarily make medical care different.     

对新型农村合作医疗费用报销制度的反思

新型农村合作医疗费用报销制度属于社会保障制度以及行政给付的范畴,与我们的生活息息相关,并能在一定程度上反映宪法规定的公民享有的社会保障权的实现情况.目前,新型农村合作医疗费用报销制度在报销范围、报销程序、报销比例等方面存在一定问题,本文认为,门诊费用一律不报销的做法过于笼统,在现实运作中不利于保障行政相对人的合法权益;医疗费用先由患者垫付再到当地报销的规定不合理;医疗费用的报销比例因医疗机构所属的行政区划不同而不同,这样的规定也值得商榷.     

American medical policy and the "crisis" of the welfare state: a comparative perspective

Health policy debates rarely include broad review of cross-national experiences with related social policies. This article addresses the connection between medical policy concerns and the development of welfare states in the advanced industrial democracies following the oil crisis of 1973-74. After examining the evidence about what actually occurred during the "crisis" years of the welfare state, the article relates the debates about the welfare state's crisis to American concerns about medical care in the 1980s. The distinctive American response to the fiscal strains of stagflation-more severe cuts in social spending than necessary based on the country's economic strength, threats of bankruptcy to produce small adjustments to large programs, and inability to address the problems of medical care as anything other than budgetary strain--is linked to American dissensus about the purposes of the welfare state.