中國醫療事故罪的司法實踐分析【醫法新論】 試閱
An Analysis of the Judicial Practice of the Crime of Medical Accident in Mainland China
1997年中華人民共和國刑法修訂後增加了「醫療事故罪」,但該罪的司法適用一直處於低頻狀態。本文收集了「中國裁判文書網」與「無訟案例」平臺上的所有「醫療事故罪」案件進行分析,發現:醫療損害糾紛一旦進入刑事程序,不論是提起附帶民事訴訟或另行提出民事訴訟,其民事賠償請求中最重要的組成部分─精神損害賠償將遇到障礙,這極大影響了病方追究醫務人員刑責的積極性;醫病雙方調解達成賠償協定對當事方各有裨益,則使刑事附帶民事訴訟的情形大幅減低;而苛刻的條件也令醫療事故罪的刑事自訴連立案都極為困難。從實證角度看,醫療事故罪有限的司法實踐適用了較為嚴格的定罪量刑標準:一、主體為典型主體,未涉及醫院管理、後勤、輔助人員是否犯罪主體的問題;二、客觀表現是違背了常規常識性的注意義務,過失極為明顯;三、損害後果多為死亡,幾乎未涉及「嚴重損害就診人身體健康」的情形;四、在刑事因果關係的認定過程中也基本遵循了事實發現、醫學評價及法律判斷的統一。中國醫療事故罪司法現狀長期不活躍、嚴格控制適用的狀態反映了對於該罪立法目標多樣性的認識,即個案中病人生命健康權的保護當然重要,而保障醫學實踐、推動醫療水準發展以促進公眾健康權同樣不可忽視。
In 1997, the criminal law of the People’s Republic of China was revised and the crime of medical accident was newly added, but the judicial application of this crime has been in a low frequency state. This paper collects and analyzes all cases of the crime from China Judgements Online and Itslaw.com. It turns out that no matter filing a supplementary civil action or new civil procedure, as long as medical malpractice disputes goes into the criminal procedure, compensation for spiritual damages, the most important part of the civil compensation, will indeed encounter obstacles. This will then greatly affect the initiative of patients to investigate criminal responsibility of medical staffs. Mediation agreement between doctor and patient will bring benefits to both parties, which then results in reduced supplementary civil action. Harsh conditions for criminal private prosecution of medical accident make it extremely difficult to even register. From the empirical perspective, the crime of medical accident adapts strict standard for both conviction and sentencing in judicial practice. Subjects of the crime are typical, instead of hospital administrative staff, support crew or auxiliary personnel. Objective response of the crime is breach of conventional duty of care, in other words, negligence is very obvious. Consequence of the damage of the crime is usually death rather than serious damage to health of patients. The recognition process of criminal causality also follows the unification of basic fact, medical evaluation and legal judgment. The application of the crime of medical accident is inactive in the long run and has been strictly controlled. It actually reflects the diversity of legislative purposes of this crime. That is, protection for rights of life and health for patients is important, while the society should not neglect the significance of ensuring medical practice or improving medical level in order to promote development public health authority either.
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