论美国医疗过失案件中注意标准的确定——从历史的视角纵向分析

医疗注意义务是整个医疗过失理论的核心，而注意标准概念则是重中之重。本文从不同时期的判例着手，重点展示美国的注意义务标准的历史发展过程和总体趋势：合同还是侵权，单一程式标准还是多因素可变标准，提高病人安全还是控制医疗费用。通过分析不同时段内法理与司法实践的主要特点，本文将美国医疗注意标准的各种影响因素逐步列出，突出行业惯例和地域因素在整个体系内的辉煌与落败。如今美国的医疗注意义务标准也面临挑战，即医疗保健体系与医疗保险改革背后对医疗费用控制的政策对它产生了冲击。

Analysis on the determination of Standard of Care in American Medical Malpractice Cases

Duty of care in medical treatment is the core of the whole medical negligence theory,and the standard of care has always been the priority.The paper studies many cases during different period of time,take a view of the process of development and trends of the standard of care in US:contract or tort law,single constant factor or multifactor variable standard,to improve patients’ health or to control medical expenses.By analyzing features of jurisprudence and judicial practice during different period of time,this paper lists all kinds of influencing factors and highlights rise and fall of the professional custom standard and locality.Today,the standard of care in American medical practice faces many challenges,in respect that it was influenced by the medical expenses controlling policies under health care system and health insurance reformation.