国际中文开源期刊平台

论医疗损害责任纠纷中医疗过失的举证责任问题

On the Burden of Evidence for Traditional Chinese Medicine Treatment Negligence in Medical Damage Liability Disputes

社会科学进展 / 2024,6(3)：844-852 / 2024-07-17 98 127

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• 作者： 张效蕾      丁潜     
• 单位：

  上海政法学院，上海

• 关键词： 医疗过失；举证责任分配；过错推定规则；自由裁量权；证明妨碍
• Medical negligence; Allocation of burden of proof; Fault presumption rule; Discretionary power; Proof of obstruction
• 摘要： 医疗过失的举证责任分配是医学问题与诉讼程序问题的交叉，为了在诉讼中平衡双方的不平等地位，减轻患者的举证压力，缓解其可能遭受的诉讼风险，立法上对医疗过失的举证责任经过了从“正置”到“倒置”再到“正置”的转变，参考域外法对医疗过失的证明，也均以偏向患者一方为衡量，在理论和判例上都运用了不同的原则降低了过失的证明标准，对我国医疗过失的证明有一定的参考价值。当前以过错推定规则作为医疗过失的归责原则，但针对三种推定过错情形仍存在一定不足，司法解释应对法律规范作出针对性的细化，并结合证明妨碍理论，在法官对医疗行为的认定上给予充分自由裁量权，从而灵活应对实践中出现的多样的医疗过失行为，化解医疗过失的证明困境。
• The allocation of burden of proof for medical negligence is an intersection of medical issues and litigation procedural issues. In order to balance the unequal status of both parties in litigation, reduce the burden of proof on patients, and alleviate the potential litigation risks they may face, the legislative burden of proof for medical negligence has undergone a transformation from "upright" to "inverted" and then to "upright". Referring to the proof of medical negligence in foreign laws, it is also measured in favor of the patient, and different principles have been applied in theory and precedent to reduce the standard of proof for negligence, which has certain reference value for the proof of medical negligence in China. Currently, the fault presumption rule is used as the principle of liability for medical malpractice, but there are still certain shortcomings in addressing the three types of presumed fault situations. Judicial interpretations should make targeted refinement of legal norms and combine the theory of obstruction of proof to give judges sufficient discretion in determining medical behavior, so as to flexibly respond to the diverse medical malpractice behaviors that occur in practice and resolve the dilemma of proving medical malpractice.
• DOI： https://doi.org/10.35534/pss.0603079
• 引用： 张效蕾，丁潜．论医疗损害责任纠纷中医疗过失的举证责任问题［J］．社会科学进展，2024，6（3）：844-852.