中医医患关系的法律性质探讨

中医医患关系既有民事法律关系又有行政法律关系,中医医患关系的法律性质是纵横交错的法律关系。明确中医医患关系的法律性质,对中医医疗卫生法治建设具有重要的理论和实践意义。     

关于构建医学生法律思维模式之必要性研究

在今年的＂声音·责任＂两会代表委员座谈会上,代表委员们又一次将＂医患关系＂推上了风口浪尖。如何处理好＂医患关系＂不是单方面医务工作者的问题,但是不可否认的是医务工作者在处理医患关系中处于关键地位。追根溯源,思维决定行为。医学院校应构建医学生在未来执业领域中的法律思维模式,以便使其在将来的执业生涯中自觉践行相关法律行为。     

Making War on Terror? Global Lessons from Northern Ireland

In place of the simple modelling employed in anti-terrorist legal discourse, this article posits an interactive model of the relationship between the state and violent political actors, exploring law's role in both the repression and mobilisation of challengers. Drawing on social movement theory, it hypothesises a process of 'legally implicated mobilisation' which takes account both of law's presence and its partial absence in 'legal grey zones' during violent conflict, and it suggests how law may impact upon key elements of the mobilisation process. The hypothesis is applied to qualitative data from Northern Ireland on violent challengers. The data point to the importance of 'messaging' about law in the state of exception, supporting claims that law can have a 'damping' effect on violent conflict. The relationship between repression and violence is partly symbiotic, and in the global 'war on terror,' prisoner-abuse may have a mobilising effect on violent challengers.     

浅议医疗损害赔偿案件中的几个问题简

近年来,随着患者维权和法律意识不断增强,法院受理的医疗损害赔偿案件不断增多。由于医疗行为的专业性和特殊性,在审理过程中,有些问题较为典型,引起了一定的争议,本文选取了优势证据制度的运用、公平责任原则的适用以及医患沟通的证据认定三个要点进行分析,以期能够为医疗损害案件的办理提供有益的帮助。     

论医患法律关系

对医患法律关系的认识上的欠缺直接影响了人们对医患关系的认识和对医疗纠纷的处理。要正确认识医患法律关系,必须先对作为普通社会关系的医患关系有所认识。从医患关系的实际情况出发,可以将医患关系中的“医”和“患”界定为与医疗活动有直接关系的双方当事人,即医院和患者。为法律所规制的医患关系,不仅只是社会关系、道德关系,更是一种特殊的医疗服务合同关系。     

Some Reflections on the Relationship between Citizenship, Access to Justice, and the Reform of Legal Aid

The reflexive, reciprocally constitutive relationship between law and society makes a substantive right of access to justice pivotal to the content of citizenship. It is therefore arguable that the establishment of legal aid, however limited in practice, was fundamental to the expanded citizenship which the post-war settlement sought to achieve. However this social form of citizenship has been attenuated by the reconfiguration of the state and the neo-liberal reconstruction of the public sector. Yet at the same time, the concepts of citizenship and social exclusion have become key discursive mechanisms in this reconstruction, including in the New Labour reform of the legal aid sector. This paper considers the various meanings attributed to the concepts of citizenship, social exclusion, and access to justice through the optic of the history of policy changes in legal aid. The impact of globalization and economic restructuring on social citizenship is explored, both in terms of the experience of recipients of public goods like legal services, and the professionals who supply them. The commensurability of the New Labour Community Legal Service (CLS) model with other models of justice is discussed. The conclusion briefly returns to the theme of law's 'citizen-constitutive' role and considers the potential of the CLS for combating social exclusion.     

A Tale of Two Regions: Diffusion of the Israeli "50 Percent Rule" from the Galilee to the Occupied West Bank

The "50 percent rule" is an Israeli judicial doctrine that has played a pivotal role since the early 1960s in deciding disputes between the Israeli government and Palestinian landholders under Article 78 of the Ottoman Land Code. It was first institutionalized during a government land-claiming campaign aimed at providing state land for settlement-based Judaization of Israel's predominantly Palestinian Galilee region. Two decades later, during a similar state land-claiming campaign, the doctrine diffused into the occupied West Bank. Drawing on spatial components of social science diffusion literature and work in the field of legal geography, this article offers a legal-historical-geographical analysis of the evolution and diffusion of the 50 percent rule. Its conclusions suggest a new spatialized approach to the study of legal transfers and transplants that conceptualizes law's movement across international borders as one component of a broader process of legal diffusion, in which internal diffusion also plays an important role.     

Legal Positivism, Law's Normativity, and the Normative Force of Legal Justification

In this article, I distinguish between a moral and a strictly legal conception of legal normativity, and argue that legal positivists can account for law's normativity in the strictly legal but not in the moral sense, while pointing out that normativity in the former sense is of little interest, at least to lawyers. I add, however, that while the moral conception of law's normativity is to be preferred to the strictly legal conception from the rather narrow viewpoint of the study of law's normativity, it is less attractive than the latter from the broader viewpoint of the study of the nature of law. I then distinguish between a moral and a strictly legal conception of the normative force of legal justification, and argue that legal positivists may without contradiction embrace the moral conception, and that therefore the analysis of the normative force of legal justification need not be a problem for legal positivists. I conclude that, on the whole, we have reason to prefer legal positivism to natural law theory. I begin by introducing the subject of jurisprudence (section 1). I then introduce the natural law/legal positivism debate, suggesting that we ought to understand it as a debate about the proper way to explicate the concept of law (section 2). I proceed to argue that legal decision-making is a matter of applying legal norms to facts, and that syllogistic reasoning plays a prominent role in legal decision-making thus conceived (section 3). Having done that, I discuss law's normativity (section 4), the normative force of legal justification (section 5), and the relation between the former and the latter (section 6). I conclude with a critical comment on Joseph Raz' understanding of the question of law's normativity (appendix).     

Being Ms B: B, autonomy and the nature of legal regulation

In this article, we question the apparent simplicity of medical law's construction of 'life and death' cases as a clash between the sanctity of life principle and patient autonomy. Our main purpose in doing so is to try to understand more fully the nature of law's regulation of the existence and non-existence of life. Specifically, we argue that, by broadening the understanding of autonomy in this area beyond a simple concern for patients' rights and self-determination, to include a focus on the individual generally, it becomes possible to identify some of the legal practices that are central to the manner in which law regulates the threshold between life and death. Through an analysis of a recent case in English law--Re B (an adult: refusal of medical treatment)--(although Australian jurisdictions presently disclose no similar, authoritative case, ours presently is almost an arbitrary choice)--we demonstrate the central role played in this regulation by tests for mental capacity, questions of character, explanation, and imagination. We conclude that medical law, at least in this context, can be theorised as a normalising practice--one in which the determination of norms often occurs through patients.     

我国国家赔偿程序存在的缺陷及其完善

在我国,制定国家赔偿法是落实宪法的需要,有助于保护公民、法人及其他组织的合法权益,有助于监督国家机关及其工作人员依法行使职权与履行职责。国家赔偿程序是进行国家赔偿活动所经历的一个过程,是赔偿请求人依法实现取得国家赔偿权利的途径、手段和保障,也是有关国家机关办理国家赔偿事务的规程,对有关国家机关起着规范和制约的作用。《国家赔偿法》包括实体与程序的规定,仅有实体不能反映国家赔偿的正当性,赔偿程序在整个赔偿制度中具有重要意义。本文将从行政赔偿程序和司法赔偿程序的缺陷及如何完善几个方面来探讨我国国家赔偿制度。     

利益分配的国家调节——论经济法的再分配功能

国家调节是对市场缺陷和市场失灵导致的利益分配失衡现象的救济与矫正,是国家介入利益分配领域后,对市场初次分配格局中存在的缺陷的补救,是在市场分配基础上的再分配。经济法作为国家调节社会经济之法,其本质属性在于国家调节,是对利益进行的再分配。以利益分配与国家调节之间关系的探究为基础,对经济法再分配功能的内涵与意义加以分析,有利于我们更好地了解经济法的功能,并运用经济法的再分配功能为建设和谐社会服务。     

民事主体与民事诉讼主体有限分离论之反思

对民事主体与民事诉讼主体的关系,我国现今学界主流持有限分离论。此论是对现行法律的误读及对两主体关系应然与实然的混淆。实体法与程序法在主体制度上的失衡,已成为两法共同有效地实现保障权利、解决民事纠纷、维护社会经济秩序等民事诉讼目的的巨大障碍。自然人、法人、非法人团体的"三元"民事主体结构,应成为我国民事立法关于民事主体结构构建的基本结构。民事主体与民事诉讼主体,应当是内涵有别但外延一致的关系。     

知情同意理论中医生说明义务的构成

医疗损害赔偿范畴内的知情同意理论是从医患关系之利益依赖模式为基础而建立的 ,具有医学伦理和医疗法律、消级性和积极性等不同层面的功能。知情同意作为医患之间的权利义务关系具有整体性 ,可构成责任基础和权利请求的独立根据。而知情同意范畴内医生说明义务 ,应以其作为有效同意之逻辑前提为宜 ,将“知情同意。作为一整体性独立义务施加于医疗机构。医生的说明义务履行充分性的判断应以理性医生标准为基础 ,并充分平衡病人标准对病人利益为保护     

医学鉴定与法的评价——以日本的判例为视点

探索性医疗技术准入制度要遵循保护患者的权利;控制医疗保健费用的过快上涨,保障全民卫生保健计划的落实;协调患者权利的保护、社会伦理和促进医疗技术的更新与发展的平衡,维护公认的伦理价值准则,维护社会生态安全等基本原则。评估制度、试验质量管理制度、风险管理制度、分级分类制度等是探索性医疗技术准入的最基本制度。     

美国医师道歉制度及其对证据法的影响

在病人安全运动的推动下，从上世纪80年代开始美国各州陆续制定了道歉法案，并逐渐确立了排除医师道歉自认效力的制度。该制度实施以来，理论界一直争议不断。各州的医师道歉制度在内容、形式、时间、对象及是否仅适用于诉讼程序方面不尽相同，也导致实务中医师因担心法律风险而拒绝道歉，以及法院挑选等问题。不过，理论和实证研究数据均表明，该制度的确能够减少医疗诉讼数量、降低医疗损害索赔数额，从而缓和医患关系。为了使其更好的发挥作用，学者们提出了对联邦证据法的修订建议。在构建和谐医患关系的目标下，该制度及其对证据法的影响，值得我国加以学习和借鉴。     

法医临床学与新冠疾病有关的鉴定问题及思考

2020年1月爆发新型冠状病毒,由疫情引发的各种问题引起社会各界高度重视,疫情过后,相关法律争议会有出现。本文针对疫情可能带来的法医临床鉴定相关问题予以思考,给出了法医临床学鉴定流程管理以及鉴定机构法律风险防控的基本思路。关于人身损害赔偿及工伤补偿中的伤残评定问题,作者具体梳理了7个可能相关的鉴定标准,并指出,肺功能障碍的条款是我们需要重点关注的内容。面对因疫情爆发而引发的医疗损害鉴定问题,作者认为,针对特殊时期的医患纠纷,鉴定人在评价医方的专家注意义务时,应充分考量各种影响因素,提倡对医疗行为相对宽松的处理原则,宜适用合理医师标准(即Bolam标准),来体现对医疗行业的尊重。本文针对新冠疾病疫情可能带来的法医学鉴定问题给予了建议和解决路径,旨在为疫情过后鉴定工作提供新思路。     

Fiduciary disclosure of medical mistakes: the duty to promptly notify patients of adverse health care events

Fiduciary obligations are imposed by the common law to ensure that a person occupying a societal role with a high potential for the manipulation of vulnerable persons exercises utmost good faith. Australian law has recognised that the doctor-patient relationship, while not wholly fiduciary, has fiduciary aspects. Amongst such duties are those prohibiting sexual or financial abuse of patients or disclosure without express authority of confidential information. One important consequence of attaching such fiduciary duties to the doctor-patient relationship is that the onus of proof falls not upon the vulnerable party (the patient), but upon the doctor (to disprove the allegation). Another is that consent cannot be pleaded as an absolute defence. In this article the authors advocate that the law should now accept that the fiduciary obligations of the doctor-patient relationship extend to creating a legal duty that any adverse health care event be promptly reported to the patient involved. The reasons for creating such a presumption, as well as its elements and exceptions, are explained.     

European Law and International Regimes: The Features of Law Beyond the Nation State

Different forms of law are perceived of as possessing differing degrees of legal quality. A quality continuum suggests itself, running from 'high quality' national law, through to 'lesser quality' European law and to 'low quality' international law. This article seeks to explain the perceived differences in the quality of these laws with reference to legal theoretical perceptions of what it is that constitutes the law's quality. It argues that only a theory of law which identifies the core of the law's integrity as lying in its ability to act as a fulcrum between spheres of social and public discourse and the exercise of power can fully explain the divergence in legal quality between national, European and international law. With specific regard to the quality of European law, it concludes by arguing that it is weakened by its relative lack of social internalisation—in comparison with a higher degree of legal and political internalisation—within the European public.     

Legal Constraints on the Use of Race in Biomedical Research: Toward a Social Justice Framework

This article addresses three questions concerning the legal regulation of the use of race as a category in biomedical research: how does the law currently encourage the use of race in biomedical research?; how might the existing legal framework constrain its use?; and what should be the law's approach to race-based biomedical research? It proposes a social justice approach that aims to promote racial equality by discouraging the use of "race" as a biological category while encouraging its use as a socio-political category to understand and investigate ways to eliminate disparities in health status, access to health care, and medical treatment.