论法人的民事能力

为建立适应社会主义市场经济客观需要的较完善的民事主体制度,需要对法人的民事能力问题进行更深入的研究。法人的民事权利能力不存在范围限制问题,也不是指法人可以享受权利的范围。法人民事权利能力的特殊性实指其与自然人民事权利能力相比所具有的特点。法人的民事行为能力同自然人一样,由于其意思能力的不同,可以划分为完全民事行为能力、限制民事行为能力和无民事行为能力。应当建立有中国特色的法人民事能力宣告制度。这一制度应包括法人民事权利能力宣告制度和行为能力宣告制度两大系统。     

违反告知义务引发医疗纠纷案例分析

告知义务是医师应尽的注意义务之一,在医疗损害赔偿诉讼中原告常以医师在医疗活动过程中未能履行告知义务造成病人损害而要求医疗机构承担赔偿责任。本文介绍了5例有关医师违反告知义务的医疗损害案件及人民法院审理结果,并对医师违反告知义务时如何判定其是否存在医疗过错以及医疗过错与损害后果之间的因果关系进行了分析和讨论,旨在为医疗损害司法鉴定提供参考。     

Not enough help for themselves--the risk of physicians to commit suicide

Physicians seem unwilling to deal with their own suicidal problems professionally. Suicide is a repressed topic. According to international studies, medical students and physicians are clearly over-represented among suicide victims. Committing suicide stands in sharp contrast to the positive image physicians enjoy as competent, strong helpers transmitting positive energy. Various studies and meta-analyses show that physicians use knowledge specific to their profession and are therefore "more successful" than the general population in committing suicide. Moreover, the data reveal a number of risk factors specifically correlating with medical practice. This is confirmed by an increased number of suicides during medical training and professional life in comparison with the general population. Gender-specific analyses show an even higher suicide risk for female physicians. In this context it cannot be excluded that out of "professional respect" cardiovascular causes of death are sometimes falsely documented in death certificates instead of suicide. Despite their special education, physicians are not very good at diagnosing their own emotional disorders and asking colleagues for adequate professional help. They rather tend to camouflage their own psychological problems also because they are afraid of occupational and personal discrimination.     

意思表示分析

意思表示是私法秩序下绝大多数法律关系的起点。意思表示作为人的内心活动的外部传达或宣示 ,必然要引出意思与表示是否一致 ,以及两者不一致时如何对已有意思表示进行判断的问题。解决这个问题的关键是如何理解意思与表示在法律交易中的实质作用及其相互关系。较可取的做法是认为意思表示的内容与效力应该通过规定性的表示获得。     

意思表示的主观要素研究

意思表示主观要素的分析应基于共时观的立场,结合特定的表示行为而进行。鉴于意思表示的行为自主性及私法自治工具的特征,可确定行为意思、表示意思、效果意思三项主观要素。主观要素欠缺时的法律后果如何,应在对行为人的自我决定与相对人的信赖保护进行利益衡量后做出妥适的制度设计。     

The ethics of managed care: a dose of realism

This article examines the ethics of medical practice under managed care from a pragmatic perspective that gives physicians more useful guidance than existing ethical statements. The article begins by stating the authors' starting premises and framework for constructing a realistic set of ethical principles: namely, that bedside rationing in some form is permissible; that medical ethics derive from physicians' role as healers; that actual agreements usually trump hypothetical ones; that ethical statements are primarily aspirational, not regulatory; and that preserving patient trust is the primary objective. The authors then articulate the following concrete ethical guides: financial incentives should influence physicians to maximize the health of the group of patients under their care; physicians should not enter into incentive arrangements that they would be embarrassed to describe accurately to their patients or that are not in common use in the market; physicians should treat each patient impartially, without regard to source of payment, and in a manner consistent with the physician's own treatment style; if physicians depart from this ideal, they must tell their patients honestly; and it is desirable, although not mandatory, to differentiate medical treatment recommendations from insurance coverage decisions by clearly assigning authority over these different roles and by having physicians to advocate for recommended treatment that is not covered.     

The determinants of the effectiveness of medical disciplinary boards: 1960–1977

The results of an empirical study to determine the reasons why some state boards of medical discipline are more active in disciplining physicians than others are presented. The study concluded that for most of the years between 1960 and 1977, the principal determinant of board vigilance was the degree to which they werenot dominated by physicians. But it was also shown that even if all the boards were controlled exclusively by nonphysicians, board activity, stated in absolute terms, would still be very small. This then leads to the inference that current efforts to change the composition of the board and create obligations for reporting miscreant physicians for various sectors in the health services industry will not produce acceptable levels of medical disciplinary board performance.     

国外官员财产申报制度的典型特征及对我国的启示

学习、借鉴国外官员财产申报制度的有益经验,对健全与完善我国官员财产申报制度具有重要意义。本文总结了国外官员财产申报制度的典型特征,探讨了国外官员财产申报制度对我们的有益启示。     

Estimating the impact of state manpower policy: a case study of reducing medical school enrollments

Perceptions of an impending oversupply of physicians have prompted proposals to reduce medical school enrollments in a number of states. Most of these states are also concerned with improving the specialty and geographic distribution of their medical manpower. The present study provides estimates of the effects of reduced numbers of in-state medical school graduates upon the future supply of physicians in Texas, and examines the medical school origin, medical specialty, and practice location of selected groups of Texas physicians. The results suggest that in Texas enrollment reductions would have no significant impact on physician supply over the next 15 years, and might actually prove counterproductive in altering physician distribution. The analysis of Texas data illuminates the unintended consequences likely to accompany a policy option that has been widely embraced by state officials largely on the basis of its intuitive appeal.     

The effect of a judicial declaration of competence on the perceived credibility of children and defendants

Purpose. Three studies were conducted to determine the effect of a judicial declaration of competence on perceptions of credibility towards a child witness and an adult defendant. Methods. Undergraduates read vignettes about a 5‐ or a 13‐year‐old child witness or an adult involved in either a sexual assault case or a motor vehicle accident case. In the child conditions, the case was either preceded by a declaration of the child's competence to testify (either specific or general declaration) or there was no mention of the competence of the child. Participants then rated the perceived credibility of both the complainant/witness and the defendant. Results. A judicial declaration of competence that was targeted at the particular child sometimes increased the credibility ratings of the child and decreased those of the defendant, sometimes to levels beyond those observed in the adult conditions. These effects on credibility were not replicated when a general declaration of all children's competence was used. In fact, the general declaration sometimes resulted in more positive ratings of the defendant. Conclusions. These results are discussed in the context of recommendations for the use of competence evaluations and declarations of competence in court.     

How effective is medical self-regulation?

Licensing and disciplining of physicians, police powers of the individual states, are carried out by boards and committees, the majority of whose members are physicians. How effective is medical self-regulation? I attempt to answer this question by examining several aspects of the disciplinary process such as the medical practice acts, inconsistencies in disciplinary actions, and the number and proportion of doctors disciplined during various periods. Also included in this study is an examination of obstacles to discipline, many of which are caused by hospitals and organized medicine. I conclude that medical self-regulation is of limited effectiveness.     

《公民权利和政治权利国际公约》的保留和解释性声明

《公民权利和政治权利国际公约》没有明文规定保留问题 ,这意味着允许缔约国提出符合该公约的目的和宗旨的保留或解释性声明 ;对该公约的强制性条款的保留、模糊的或一般性的保留 ,往往被认为是不可接受的 ;对该公约的强制性条款不宜提出保留 ,但可以作出解释性声明 ;对该公约的非强制性条款可以提出保留也可作出解释性声明 ;各国的保留和解释性声明是从自己的国情出发的 ,表明了国际人权保护的特殊性。其他国家的保留或解释性声明以及反对意见 ,对我国提出保留或解释性声明、解释和适用该公约、完善我国的相关法律 ,都有重要借鉴意义。     

Prescribing privacy: the uncertain role of the physician in the protection of patient privacy

Because medical records are now more comprehensive than ever before, they increasingly are being demanded for uses both inside and outside of the medical profession. Mr. Gellman contends that existing ethical and legal guidance is inadequate to aid physicians in dealing with the confidentiality issues raised when patient information is requested or demanded from them, and supports this contention by examining the dilemmas faced by physicians presented with such requests or demands. He concludes that ethical and judicial guidance will continue to be inadequate, and that the only practical way to develop suitable guidance is through legislation.     

Health law and mental health law courses in US medical schools

Results of a recent survey of all 127 medical schools in the United States indicate that about two fifths of medical schools offer a separate course that focuses on topics in medicine and law and a number of medical schools integrate health law topics into other courses. Presumably reflecting concern over temporary medical malpractice litigation, most health law courses include informed consent, medical malpractice, privileged/confidential information, and patients' rights. In contrast, schools that offer a course on psychiatry and law are clearly in a minority. It is elective at all but two of the 13 schools with such a course. Although the hours allotted and the format of these courses vary greatly, courses typically cover most of the topics listed on the questionnaire. Most of the courses are led or co-led by a member of the American Academy of Psychiatry and the Law. Information from two additional surveys suggests two related factors that may influence a medical school to present a separate course on health law. Medical licensing boards were surveyed to determine which states require physicians to be examined on health law. In two states that require physicians to pass a separate medical jurisprudence examination for licensure, all four-year medical schools offer a course on health law for medical students. Medical malpractice companies providing coverage in all 50 states and the District of Columbia were surveyed to determine which states have the highest claim rates. The claim rate per 1,000 physicians insured per year was significantly greater in states with health law courses than was the rate in states without such courses.     

Ontario court affirms that medical marijuana regulations are unconstitutional

On 7 October 2003, the Ontario Court of Appeal upheld the Ontario Superior Court of Justice decision in Hitzig, which found that the Marihuana Medical Access Regulations (MMAR) represented an unconstitutional barrier to accessing a legal supply of marijuana for persons with a recognized medical need. The Court of Appeal tailored its remedial order by striking down the second specialist test required for certain applicants, and eliminating the unconstitutional eligibility and supply provisions, rather than declaring unconstitutional the entire MMAR as the lower court had done. The court's declaration was made effective immediately, in order to maintain the prohibition for non-medicinal possession of marijuana under section 4 of the Controlled Drugs and Substances Act (CDSA), and to constitutionalize the medical exemption for marijuana possession created under the MMAR.     

Legal considerations of sleep deprivation among resident physicians

Medical training in the United States often takes the form of a grueling endurance test in which patients are often those most at risk. This Article discusses sleep deprivation among resident physicians in the United States with an eye towards resolving the problem through legal channels. It analyzes the effects of sleep deprivation on resident physicians, with subsequent discussion of the implications for patient care and medical training. Next, it makes comparisons to medical training in other developed nations, as well as regulations that exist in the airline and trucking industries, where public safety is a principal concern. Furthermore, this Article discusses proposals to mend the dilemmas created by sleep-deprived resident physicians through statutory and regulatory reform, deterrence by way of tort law, and unionization or collective bargaining.     

医疗事故损害赔偿问题研究(1)(山西大学2004届法律硕士研究生毕业论文)

本文以《医疗事故条例》与民事法律、法规及司法解释的冲突为切入点,首先从医疗事故的构成要件着手分析,将医疗事故界定为“医疗机构及其工作人员在医疗活动中,违反医疗卫生法律、行政法规、部门规章和诊疗护理规范、常规,过错造成患者人身损害的事故”,拓宽了医疗事故的范围,并在此基础上着重强调医疗机构的谨慎注意义务,缩小了医疗事故的免责事由。其次,经过分析认为医疗事故损害赔偿责任的性质是侵权责任与违约责任的竞合,在实践中应根据当事人意思自治原则区别对待,适用不同的归责原则,同时指出了赔偿范围与标准以及医疗事故鉴定的不足,批驳了“不属于医疗事故的,不承担赔偿责任”的错误观点,论证了惩罚性赔偿原则在医疗事故损害赔偿纠纷中适用的可行性,提出了医疗事故网上鉴定的设想。最后为了强化对患者的司法救济,分散医疗机构的风险,消化医疗机构的损失,平衡医患双方的利益冲突,构筑完整的医疗事故损害赔偿体系,对医疗责任保险的保险范围、除外责任提出了自己的看法,同时提出医事法律应借鉴其他法律的相关规定,对医疗责任保险做出强制投保规定的设想。     

论故意非真实意思表示

民法以确认和保护自由为己任,而其实现的手段是私法自治。法律行为作为私法自治实现的工具,其基本要素意思表示在民法中的作用和位置便更为凸显。意思与表示有时不一致,而表意人故意为之便是其中的一种。在系统分析表意人故意使意思与表示不一致的各种形态及其在国外的立法例,并将我国《民法通则》和《合同法》关于虚伪表示的规定与国外的相关规定相比较后,明确指出我国缺乏就游戏表示、心中保留和隐藏行为等行为类型做出相应规范,在通谋虚伪表示方面的规定也存在一定残缺。因此,就上述立法上的缺陷提出在将来的民法典中应如何进行完善的拙见。