李学博^1，2  苏锐冰²  廖林林²  于晓军²

（1.山东政法学院刑事司法学院，济南 250014；2.汕头大学医学院，汕头 515041）

【摘 要】死亡证明对于国家人口信息管理、生命健康数据统计和相关国计民生政策的制定，特别是涉及刑事、民事、行政和保险等案件的审理，均具有重要的法律意义。本文基于世界卫生组织（The World Health Organization, WHO）修订的 11 次《国际疾病分类》（The International Classification of Diseases, ICD）和卫生部修订的 3 次死因分类，讨论了医学死亡证明相关问题，法医学死亡原因的表述，并从哲学、医学、法学和逻辑学等角度分析了死亡因果关系，即在具体案件中，判断与死亡相关的各种病变、外伤等因素时，须同时综合考虑空间关系、时间关系、定性联系和逻辑量化关系四个条件，方可体现鉴定意见的客观性、全面性和科学性。本文还在 ICD 基础上，结合法医学实践，提出了八大类因果关系及其原因力分析的概念，并与国内外现行的因果关系及其原因力分析进行了比较，尤其对法医学实践中的事实因果关系与司法审判中的法律因果关系及其原因力进行了分析和比较，旨在为法医学伤亡案件鉴定意见的规范和统一提供相关参考，并为医学死亡证明的国际接轨提供理论依据。

【关键词】法医病理学；死因分析；死因分类；死亡证明；WHO-ICD

【中图分类号】D915.13

【文献标识码】A

【文章编号】1674-1226（2019）06-0741-13

Discussion and suggestions on unifying medical death certificate and the appraisal opinions on the cause of death in forensic medicine (Li Xuebo^1，2,Su Ruibing²,Liao Linlin²,Yu Xiaojun²/1. College of criminal justice, Shandong University of Political Science and Law, Jinan 250014; 2.Shantou University Medical College, Shantou,515041)

【Abstract】The death certificate is of great legal significance for the management of national population information, the statistics of life and health data and the formulation of relevant national economy and people's livelihood policies, especially for the trial of criminal cases, civil cases and administrative cases, as well as the handling of cases involving insurance. Based on eleven times of the international classification of diseases (ICD) revised by the World Health Organization (WHO) and three times of the classification of causes of death revised by the Ministry of Health, this paper discussed the problems related to death certification, the expression of causes of death in forensic medicine, and analyzed the causal relationship of death from the perspective of philosophy,medicine, law and logic. That is to say, in actual cases, when judging various pathological changes, trauma and other factors related to death, it is necessary to comprehensively consider four conditions: spatial relationship, temporal relationship,qualitative relationship and logical quantitative relationship, so as to reflect the objectivity, comprehensiveness and scientificity of the appraisal opinions. It is necessary and urgent to establish a unified and standardized format for the medicolegal death certificates which is in line with the medical death certificate. On the basis of ICD and the practice of forensic medicine, this paper put forward the concept of eight categories of causal relationship and causal force analysis, and compared it with the current causal relationship and causal force analysis at home and abroad, especially the factual causal relationship in the practice of forensic medicine, as well as the legal causal relationship and causal force in the judicial trial, in order to standardize appraisal opinions on the forensic medicine in casualty cases. Meanwhile, it also provided theoretical basis for the international practice of medical death certificate.

【Key Words】Forensic pathology; Analysis of death causes; Classification of causes of death; Death certificate; WHO-ICD