杨天潼

（中国政法大学证据科学研究院，北京 100088）

【摘 要】美国医学会第六版的《永久性残损评定指南》，代表了残损评定领域最新的、革命性进展。《永久性残损评定指南》旨在完善残损等级评定方法、提高评定的准确程度、增强评定结论的可信度，并使评定系数标准化，为残损评定提供稳定的、完备的方法。《永久性残损评定指南》最终目的在于，使利用该指南进行残损等级评定的结论具有权威性、公正性，并为评定所涉及的各方所认可。《永久性残损评定指南》的检查方法、术语以及分析架构以世界卫生组织的《国际功能、残疾和健康分类》为基础，涵盖了当今美国及国际社会最新有关残损等级评定研究成果，包括更为复杂、广泛的医学诊断手段，和更为准确功能丧失系数的解释说明等内容。所有的这些更新内容均有利于帮助鉴定人，在残损等级评定过程中消除争议，提高评定准确率。本文简要介绍了《永久性残损评定指南》第六版的基础概念，为我国法医临床学研究、借鉴《永久性残损评定指南》进行伤残评定提供依据。

【关键词】法医临床学；残损；残疾；评定

【中图分类号】D918.9

【文献标识码】A

【文章编号】1674-1226（2014）01-0064-17

Conceptual Foundations of Guides to the Evaluation of Permanent Impairment (American Medical Association.Sixth Edition). Yang Tiantong. Center of Cooperative Innovation for Judicial Civilization, China University of Political Science and Law & Jinlin University & Wuhan University/ Key Laboratory of Evidence Science (China University of Political Science and Law), Ministry of Education, Beijing, PRC 100088.

【Abstract】The sixth edition of American Medical Association’s Guides to the Evaluation of Permanent Impairment represents the latest revolutionary advancement in the field of impairment evaluation. A consistent, welldesigned method was adopted and applied to each chapter to improve the impairment ratings, promote the degree of accuracy, enhance the reliability of the evaluating conclusion and standardize the rating coefficient. The ultimate aim is to provide an impairment rating guide that is authoritative, fair, and approved by all involved parties. The examination method, terminology and the analytical framework applied in Guides to the Evaluation of Permanent Impairment cover the latest research achievements of American or international impairment ratings based on the World Health Organization’s International Classification of Functioning, Disability and Health (ICF), including a more comprehensive and expanded diagnostic approach, and increased transparency and precision of the impairment ratings. These features benefit all stakeholders by minimizing conflict and improving the assessment accuracy. The aim of the present study was to introduce foundation concepts of the sixth edition of Guides to the Evaluation of Permanent Impairment, and provide the basis for forensic clinical medicine research and the assessment of impairment and disability in China.

【Key Words】Forensic clinical, Impairment, Disability, Assessment