论医患关系的法律属性及处理医事纠纷的特有原则（下）

医事法(又称卫生法)究竟是属于民法的调整范畴还是属于行政法的范畴,对此,国内学术界争议很大。本文从医学科学与医疗行为的本质特征入手,揭示了医患关系并不具备民事法律关系所必须具备的主体平等、双方自愿及等价有偿互惠互利三大特征中的任何一个特征,同时也不存在行政主体与行政相对人的关系。为此,文章首次提出了医事法既不调整横向的民事法律关系,也不调整纵向的行政法律关系,而是调整斜向的医事法律关系的一门独立的法律体系的理论。并根据医患关系的特征,得出了处理医患纠纷案件的特有原则与规则,为指导医患纠纷的公正处理,提供了理论依据。     

Corruption and reforms: A case of Poland's medical sector

This study focuses on the effects of Poland's reforms in the period 1990–2005 on corruption in the health care system. In the last 15 years Poland has transformed its economy drastically, introducing market-oriented reforms into almost every aspect of its economy. In this study we consider how different reforms changed incentives and mechanisms facilitating corruption in the medical care sector. Our conclusion is that corruption in Poland's medical sector has worsened since the onset of the marketization reforms. We support this conclusion primarily by analyzing changes in incentives for corruption and the number of mechanisms facilitating it. In addition, where available, quantitative data are provided, though we recognize that numerical estimates of corruption are subject to substantial error. We focus on three major forms of corruption: patient payments to secure medical treatment or improve its quality, payments from industry (mostly pharmaceutical and medical equipment producers), and the use by physicians of free public facilities for private patients.     

Reviews

Books reviewed:
Hodges, Multi-Party Actions
Katz et al., Cross Currents: Family Law and Policy in the US and England
Paulus, Die internationale Gemeinschaft in Völkerrecht
Norrie, Punishment, Responsibility, and Justice: A Relational Critique
Bell, Peace Agreements and Human Rights
Powell, Sir James Whitelock's Liber Famerlicus 1570–1632: Law and Politics in Early Stuart England
Clam, Droit et société chez Niklas Luhmann. La contingence des normes     

医疗事故罪客观方面要件研究

医疗事故罪客观方面的要件包括 :1 医务人员在正常的诊疗护理的职务工作中有严重不负责任的行为 ;2 上述行为造成了就诊人死亡或者严重损害就诊人身体健康的后果 ;3 医务人员严重不负责任的行为 ,与就诊人死亡或身体健康严重受损的后果之间 ,具有刑法上的因果关系。     

高位视路损伤与管内段间接视神经损伤的比较

目的 探讨高位视路损伤的法医学鉴定问题。方法 搜集11例头部外伤致高位视路损伤的案例资料,与随机选取的20例管内段间接视神经损伤的案例资料进行比较,并就相关临床检查所见、电视野及闪光VEP特征进行分析。结果 与视神经损伤相比,高位视路损伤的临床常规检查,除视功能障碍的主诉外瞳孔对光反射及眼底均无阳性所见;电视野检查表现为双眼同向性偏盲,管内段视神经损伤表现为单眼视野缺损。在11例高位视路损伤者中,8例为枕叶皮层损伤,闪光VEP表现为双眼P1波潜伏期轻度延长,波幅基本正常;3例为皮层下损伤,表现为P1波潜伏期明显延长,波幅明显降低。视神经损伤闪光VEP表现为伤眼PI波潜伏期明显延长,波幅明显降低,甚至无波诱出。结论双眼视野同向性偏盲是高位视路损伤的特征性改变,高位视路损伤闪光VEP的异常率较低,但一旦双眼闪光VEP异常可以支持高位视路损伤的诊断,鉴定时应同时结合头颅CT及脑电图结果综合分析,加以确认高位视路损伤的存在。     

The Role of Perpetrator Alcohol Use in the Injury Outcomes of Intimate Assaults

Little research has been conducted on the role of perpetrator alcohol use in the injury outcomes of intimate assaults, although alcohol use by an intimate partner may be related to more severe assault outcomes (physical injury and need for medical attention) than is no alcohol use. The role of perceived perpetrator alcohol use in the injury outcomes of intimate assaults (N = 909) was analyzed using 1992–1996 National Crime Victimization Survey data. Logistic regression analyses demonstrated that perpetrator alcohol use was associated with increased likelihood of physical injury and marginally associated with more medical attention seeking by the victim when demographic variables and assault characteristics were controlled. Suggestions for future research on the relationship between alcohol and intimate assault outcomes are presented.     

医疗纠纷的法律误区与建立医疗纠纷仲裁制度的探讨

医疗纠纷是当今社会的热点问题之一,由于我国医疗纠纷在法律属性的界定上存在误区,致使医疗纠纷解决机制严重滞后,医患关系日趋紧张,卫生立法及配套改革显得刻不容缓。本文在分析医疗纠纷产生的原因及医患关系的法律属性的基础上,对建立我国医疗纠纷仲裁制度进行了探讨。     

Equity,access, and outcomes: The status of the art

A rationale for including analyses of outcome in evaluation of the impact and equity of changes in health care policy for the poor is presented. We first discuss problems in defining equity in and access to health care. Equity in access to health care requires equality of access only to those services that are believed to be efficacious. Three cost-containment strategies (restrictions in eligibility, coinsurance, and capitation) are then examined, and their limitations are discussed. Finally, directions for future research focusing on outcomes are suggested. Rather than using access to care to assess outcome, outcome is viewed as the framework for assessing access and equity.     

病人 罪犯与公民——吸毒者的社会救助研究

我国传统的救助行为将吸毒者当成病人和罪犯,恰好忽略了吸毒者社会身份这一重要方面。即吸毒者首先是公民。作为公民的吸毒者应该享有国家社会政策赋予公民的有关社会保障,社会福利、公共医疗救助、社会关怀和社会服务等方面的权力。从目前的情况看,不管是在理论还是实践方面,对吸毒者的救助主要集中于探讨病人和罪犯这两个层面,对社会救助这个层面的关注比较少。因些,本文着重论述吸毒者的社会救助。