Institutional memory,institutional capacity: narratives of failed biomedical encounters in East Africa

Abstract

This paper focuses on a series of failed medical encounters that took place in East Africa in the 1950s and after, and explores how the organizations involved ? the Kenyan Division of Insect Borne Diseases, the East African Medical Survey, and the Tanzanian National Institute of Medical Research ? chose to document and remember these events. The examples focus on medical encounters characterized by disagreements and miscommunications that stymied productive work. In each case, failures were remembered in very stylized and restructured ways that stressed the validity of the science and the valor of the scientists while drawing on tropes of African communities as irrational and superstitious. Capacity is built and maintained by having a functional institutional memory, which includes recounting failure and an ability to integrate knowledge from failure, leading to new approaches. It is found that remembering failures in such stylized forms systematically diminished the functionality of their institutional memory.     

论我国医疗损害责任制度的修改与完善——以《民法典·侵权责任编草案(三审稿)》的规定为视角

我国正在起草和制定的《民法典·侵权责任编草案(三审稿)》修订和完善了医疗损害责任的部分规则,使医疗损害责任规则体系更具有科学性和可操作性。为了满足司法实践的需要,保持法律规范的先进性和前瞻性,有必要完善知情同意规则、规定医疗技术损害责任的认定标准和考虑的因素、多个医疗机构的损害责任、误诊损害责任、医师外出会诊损害责任、完善医疗产品责任、远程医疗损害责任、医疗机会丧失损害责任、医疗管理损害责任以及医疗损害限额赔偿责任等方面的法律规则。我国立法机关应当利用制定民法典的契机,采纳司法实务界和学术界提出的有效解决医疗损害责任纠纷的建议,修改和完善《侵权责任法》确立的医疗损害责任制度,构建科学的医疗损害责任法律体系,为健康中国战略目标的实现提供法律保障。     

论我国刑事强制医疗程序之建构与完善

2012年《刑事诉讼法》增设专章规定了“对实施暴力行为的精神病人的强制医疗程序”,初步构建起了刑事强制医疗程序,但还存在适用对象过窄、适用条件模糊、鉴定启动垄断、权利救济不力等问题。应当借鉴域外有益的经验,秉持保卫社会与保障权利并重的精神,对我国刑事强制医疗程序的适用对象、适用条件、启动程序、决定程序、救济程序等方面予以进一步完善。     

Secondary Iatrogenic Harm: Claims for Psychiatric Damage Following a Death Caused by Medical Error

The purpose of this paper is to investigate the feasibility of claims for psychiatric damage following the death of a family member, where that death has been caused by medical error. ¹ The relative's position is a subject of heightened interest since the exposure of the plight of the parents involved in the UK organ scandal, ² and in the case of an iatrogenic death it is, of course, the family who are essentially the focus of the law's attempts to provide redress. Whilst the cases of deceased patients' relatives seeking damages for mental harm are inherently problematic in light of the restrictive secondary victim criteria applicable to psychiatric damage claims, a close look at the rules which permeate this area of compensation reveals that denying compensation to the relative suffering psychiatric harm is difficult to sustain. ³     

对新《刑法》第18条的理解与运用

本文就我国新刑法第18条中精神病的涵义,精神病患者刑事责任能力评定,精神病的医学鉴定以及对精神病人的监护治疗问题谈个人看法。供执法者和鉴定工作者在处理有关精神疾病案件时参考。     

试论《民法通则》第一百三十二条在医疗损害赔偿中的适用

民事法律中“公平责任”和“公平原则”在内涵上有着本质的区别,《民法通则》第一百三十二条“当事人对造成的损害都没有过错的,可以根据实际情况,由当事人分担民事责任”是“公平原则”在侵权行为法中的具体体现,具体到医疗损害赔偿中应坚持贯彻公平原则。但是目前在医疗损害赔偿案件中,有一种滥用《民法通则》第一百三十二条的现象。笔者针对司法实践中的此种现象,试图说明医疗损害赔偿案件适用《民法通则》第一百三十二条的原则。     

规范处理医疗损害赔偿的几个关键性问题

医疗损害赔偿是现阶段医疗纠纷处理中最现实和最敏感的问题,如何公正、合理、有效地处理医疗损害赔偿问题一直被社会公众所关注。本文围绕如何正确理解医疗损害赔偿责任的性质,准确把握法律适用和规范赔偿处理行为等关键性影响因素作出分析和阐述,并力求在法理性与规范性方面为医疗损害赔偿问题的处理提供相关借鉴。     

完善医疗救助制度 构建社会主义和谐社会

医疗救助是社会救助的重要内容,是社会保障体系的重要组成部分,是促进社会公平、维护社会稳定的重要手段,是构建社会主义和谐社会的必然要求.建立和完善医疗救助必须加大财政投入,拓宽筹资渠道,建立健全法律法规.     

病人家属参与医疗决定之法律研究

在我国目前的收入结构与医疗体制之下,对于大多数人而言,一旦面对大的病患风险,家属往往是其医疗成本以及医疗后果的直接承担者。当医疗决定牵涉到家庭成员的重大利益时,患者自主权应该受到家属决定权的制约。病人并非如病患自主理论所预设的前提一样是一个自由且理性的选择者,而是一个组织社群所有关系的总和,因此个人自决并不应该豁免其社群义务,尤其是对于家庭之义务。即使是成年具有意思能力病人其家属亦应具有相应的权利。     

探索性医疗技术临床准入立法的基本原则和基本制度

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。