—兼论循证医学在医疗过失认定中的地位

何心 张雪

（哈尔滨医科大学人文社会科学学院，哈尔滨 150081）

【摘 要】医疗侵权诉讼中医疗过失的认定始终是一个热门而且沉重的话题。我国《侵权责任法》在医疗过失认定中坚守了“过错责任原则”，但由于规定较模糊和缺乏阐释，法官对依照何种标准认定医疗过失陷入了困境。有鉴于此，本文在科学界定医疗过失概念的基础上，考察了域外法医疗过失认定的抽象标准和具体标准，阐述了域外法理论和实务中循证医学在医疗过失中的优势和地位，最后结合我国现行的医疗过失认定标准的规定，从医疗过失认定抽象标准的完善、注意义务类型化和文本化、确立循证医学的证据地位、注意医疗过失认定标准和现有法律制度的衔接四个方面提出了建议和对策，以期为实务中医疗侵权诉讼的合理解决提供理论上的依据。

【关键词】医疗过失 ；认定标准 ；注意义务 ；循证医

【中图分类号】D915.13

【文献标识码】A

【文章编号】1674-1226（2015）01-0107-09

Improvement of the standard in identifying medical malpractice from the perspective of tort law: together with discussing the status of evidence-based medicine in medical malpractice identification. He Xin, Zhang Xue. Department of Humanities and Social Science, Harbin Medical University, Harbin 150081

【Abstract】In the medical tort lawsuits, identifying medical malpractice is always a hot and serious topic. “Negligence responsibility principle” has been followed by Chinese Tort Liability Law in medical malpractice identifications, but the standard of identifying medical negligence is still fuzzy and lacks illustrations and explanations, which brings judges with difficulties. Thus, in this paper we define medical malpractice, study the standard of abstract and specific identification of medical malpractice, as well as explain advantage and status of evidence-based medicine of other countries in theories and in practice. Finally, we combine Chinese regulations together with some suggestion of improving the abstract standard,classifying the duty of care, establishing the evidence status of evidence-based medicine, connecting of identifying medical negligence and the current-existing legal system, and we do hope to provide theoretical basis for reasonable solutions for medical tort lawsuits in practice.

【Key Words】 Medical malpractice, Standard of identification, Duty of care, Evidence-based medicine