摘要
对于医疗侵权因果关系的判断,仍有必要根据作为通说的相当因果关系理论来完成。该理论可以对医疗鉴定、医学知识、医疗法规等现象做出系统性解释,并能为司法实质性介入因果关系的判断提供详细路径。条件关系的确认在于全面提供各种致害可能的一般性以及具体性分析,通过“富有经验的观察者”标准再进一步考虑何种可能符合通常情况。医疗鉴定是以科学层面是否确定为标准,而相当性判断是以法律层面的“富有经验的观察者”能否预见为标准,应当厘清不同层面的视角和标准。对于依据不确定医学知识所确认的条件关系,在相当性判断中须结合个案因素来弥补科学认知上的缺陷,包括疾病的情况、诊疗的难易、诊疗的经济、损害的严重等。考察医疗法规目的可以纠正相当性判断结果的偏差,为患者利益、特殊体质以及医方不作为等影响因果关系的因素提供解释依据。相当因果关系理论的运用不仅有确认因果关系的作用,还有限制责任的功能,这是其他规则无法替代的。
For the judgment of causation in medical torts,it is still necessary to complete according to the theory of adequacy causation as a general theory.This theory can provide a systematic explanation of the phenomena such as medical evaluation,medical knowledge,medical regulations,and can provide a detailed path for judicial substantive involvement in the judgment of causation.The identification of conditional relationships is based on a general as well as a specific analysis of the various possibilities of harm,and further consideration of what might be usual through the criterion of the“experienced observer”.The different perspectives and criteria should be clarified,as medical evaluation is based on scientific certainty,whereas adequacy is based on whether an“experienced observer”could have foreseen it at the legal level.For the conditional relationship recognized based on uncertain medical knowledge,in the judgment of adequacy,it is necessary to take into account the case-by-case factors to make up for the shortcomings of scientific cognition,including the circumstances of the disease,the difficulty of treatment,the economy of treatment,and the severity of the damage,and so on.Examining the purpose of medical regulations can correct the bias of the judgment results of adequacy,and provide an explanatory basis for the patient’s interests,special physical condition,and medical inaction and other factors affecting the causation.The application of the theory of adequacy causation not only has the function of confirming causation,but also has the function of limiting liability,which cannot be replaced by other rules.
出处
《南大法学》
CSSCI
2024年第6期54-74,共21页
NanJing University Law Journal
基金
中国社会科学院学科建设“登峰战略”资助计划资助,编号DF2023YS32。
关键词
医疗侵权
因果关系
医疗鉴定
相当性
法规目的
Medical Torts
Causation
Medical Evaluation
Adequacy
Statutory Purpose
