赵西巨 李心沁

（1.山东中医药大学，济南 250355 ；2.山东中医药大学附属医院，济南 250011）

【摘 要】我国《侵权责任法》不应满足于只是列举医生告知义务的范围。以患者为导向、面向“实质性”信息的一般性信息告知标准应成为我国立法的发展方向。应避免概括地让医疗专家鉴定“医生是否违反告知义务”、“医疗过错行为与损害结果之间是否存在因果关系”。医疗过错和因果关系的认定应化解为法官对一系列具体因素的综合考察。“医学判断”与“一般人知识”的区分有助于厘清哪些具体事项有赖于医疗鉴定，哪些具体事项应归入一般人（包括法官）的知识范围而不需要请医疗专家鉴定。医疗损害鉴定的对象仅限于常人知识不能及的医学专业问题。

【关键词】知情同意；医疗损害鉴定；医学判断；一般人知识应

【中图分类号】D915.13

【文献标识码】A

【文章编号】1674-1226（2015）01-0094-13

The subject of medical damage authentication within disputes concerning breach of doctor’s duty to inform. Zhao Xiju, Li Xinqin. 1.Department of Law, Shandong University of Traditional Chinese Medicine; 2.Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250011

【Abstract】It is not enough for Chinese Tort Liability Law to just list information that falls within a doctor’s duty to inform. There is a need for Chinese legislation to develop a patient-oriented, general standard of information disclosure, such as the materiality test. It is not wise to generally put the whole task of identifying “whether the doctor breached his or her duty to inform” and “whether there is casual link between the medical malpractice and the damage” on the shoulders of medical experts. The establishment of medical malpractice and causation shall depend on trial judge’s overall weighing on a wide list of specific factors, medical and nonmedical. The distinction between “medical judgment” and “common/ordinary knowledge” will make it easier to sort out which factors shall be subject to medical expert authentication and which shall not. The issues that call for medical damage authentication should be confined to those that are beyond the reach of layperson knowledge.

【Key Words】 Informed consent, Medical damage authentication, Medical judgment, Layperson knowledge