医疗损害赔偿案件一例评析

目前,法院在审理医疗损害赔偿案件时的一些观念与医学界有一定的冲突,医疗界和司法界对于医疗过错的认定、损害后果的发生、因果关系的认定以及责任大小的裁判等问题争议较大,部分医疗损害案件的判决结果原、被告双方都难以接受,历经两审仍争论不休。本文试图通过对一起典型案例的分析来为医疗损害赔偿案件的审理提供一些有益的建议。     

英韩两国医疗保险制度整合过程比较研究——以行动舞台的层次关系为核心

本文从制度主义的视角,利用层次性行动舞台为核心分析概念,对1911～1948年英国与1963～2007年韩国的健康保险制度整合过程进行了比较,结论是尽管在个人层次以及国家层次上两国情况都很类似,但是其根本区别在社会层次内部以及社会层次与国家层次的互动方面的不同。韩国经办组织层次与政治层次之间形成了一个劳使政三方委员会,政府充分利用这个组织框架达成的协议实现了医疗保险体系整合,而英国的社会层次表现为相互钳制,缺乏跟政治层面的良性互动,故无法实现整合。     

双肺移植引发医疗纠纷的思考

器官移植对于挽救终末期器官功能衰竭病人的生命具有重要意义，但是在没有充分权衡移植手术利弊的情况下，对患者施行移植技术尚不成熟的双肺移植手术，进行探索性试验的医疗行为违背了生命伦理学和医生的职业道德，医患双方由此发生医疗纠纷也是不可避免的。在司法实践中，由于法律之间的冲突，使医疗纠纷案件的处理陷入了困境，要想使医疗纠纷步入良性、理性处理的轨道，应建立多元化纠纷解决机制或者制定一部位阶较高，专门调整医疗损害赔偿法律关系的法律。     

美国医疗纠纷替代性解决机制研析

美国医疗纠纷替代性纠纷解决机制卓有成效,其不仅包含作为传统非讼手段的调解、仲裁、和解,还创设出监察员制度、事实调查、建立共识、混合式ADR、聘雇退休法官程序、微型审理、简易陪审团审判、诉前审查庭等多种方式。因受到司法机关与行政单位的重视和民间团体的大力支持,美国ADR制度已经发展成为与民事诉讼制度双轨并行、相互补充的重要纠纷解决机制。针对我国今年医闹事件频发,伤医事件愈演愈烈的情况,将ADR机制导引入国内医疗纠纷领域,不失为一条缓和医患关系、促进医患沟通、妥善解决医疗纠纷的有效可行的途径。     

医院设置医务社会工作部门相关问题研究

医务社会工作是一种助人性质的工作,在医院内的职能包括开展个案辅助工作、协调医患关系等。医务社会工作在医院内作为一个独立的部门也会遇到很多问题,因此应该提供相应策略,从而让医务社会工作更好地为医院服务,为构建和谐社会贡献自己的力量。     

Rethinking the medical causes of infant death in early modern Europe: a closer look at church registers and medical terminology

The historical roots of the prevailing hypothesis about the main causes of high infant mortality in Europe in the last four centuries are presented in detail focusing on German sources and publications. Assumptions about infections being the main cause of deaths during infancy clearly need to be reevaluated. The terminology of early sources has passed many steps of translation and interpretation. In the old church registers, wording in the local vernacular merely described the most visible symptoms before the final stages of diseases. Scientific medicine and its terminology repeatedly went astray before real pediatric competence was acquired in the nutritional physiology of infants. The combination of different kinds of evidence points to serious flaws in the prevailing hypothesis, while source data and publications confirm a different conclusion: inadequate nutrition due to early weaning and unsuitable substitute food caused the specific set of symptoms described in the historical sources. Medical evidence about infant malnutrition in developing countries supports this new interpretation.     

Singapore: The Limits of a Technocratic Approach to Health Care

Being a tiny, easily managed polity run by Western-educated technocrats, Singapore is an ideal laboratory for those who believe that there is a “logical” answer to the problem of health-care funding in economically advanced societies. Certainly the ruling elite in this not-very-democratic country is convinced that Singapore is the epitome of a rational, technocratic state in which rule is based on supposedly impartial, objective criteria. The government's achievements in the delivery of health care are at the forefront of its showcase of technocratic achievements. This article uses the Singapore government's innovations in health-care funding as a case study to explore and test the limitations of trying to apply purist technocratic premises and methodologies to governance. The limitations it uncovers raise the question of whether a technocratic approach to governance can ever deliver the promised results and suggests that the attraction of “technocracy” is a chimera.     

What Can We Learn from a University that Rewards Faculty Practice?

What conditions, including standards for promotion and tenure, should we be cultivating at universities if we want scholar practitioners (or pracademics) in conflict‐related fields to thrive in academic settings? This article examines the Center for Justice and Peacebuilding at Eastern Mennonite University as an example of “positive deviance” — a university and an academic program that wholeheartedly support faculty members who engage in extensive practice, including long‐term involvement with peacebuilding processes. Three conditions — location, culture, and the application of peacebuilding strategies within the university — have given rise to and continue to support this system even as the university embraces a commitment to increasing scholarly productivity by faculty members.     

医疗行为中患者承诺的一般效力与例外——个人自决权与社会连带之限制的平衡

本文从患者承诺作为医疗行为的正当性根据出发,从比较法的视角观察了医疗行为中患者承诺的一般有效要件及特殊情形下的豁免与例外等诸种情形,用尊重个人自决权和社会连带之限制的理论阐释了前述情形,最后通过对＂安乐死＂的简要分析初步回答了如何平衡患者的个人自决权与社会连带之限制这一问题。