孙东东 张 鹏

【摘 要】 《侵权责任法》第七章留下诸如当事人选择、案由确定、医疗过错和因果关系判断标准、病历证据属性、鉴定体制等许多实践操作的难题。对这些司法实践难题的解决，最高人民法院目前已经出台了部分司法解释，但实质性的问题都没有得到解决。由于最高人民法院出台司法解释有一个过程，在司法解释尚未出台之际，地方高级人民法院针对当地的司法实践的具体情况，可以因地适宜出台地方司法审判指导文件。我们现在看到的浙江、江苏、上海、北京四个省市的地方审判指导文件，解决了各地审理医疗损害赔偿纠纷案件中的一些难题，在制度上有创新之处，且具有极强的可操作性。地方司法审判指导文件的出台，既解决了当前地方上医疗损害赔偿案件审理的困境，也为最高人民法院制定司法解释积累经验。

【关键词】 医疗损害赔偿；诉讼；难题；对策

【中图分类号】 D913

【文献标识码】 A

【文章编号】 1674-1226（2011）03-0357-20

Difficult Litigation Issues on Compensation for Medical Malpractice and Trial Countermeasures. Sun Dongdong, Peking University law school,Beijing 100871; Zhang Peng ,Institute of Evidence Law and Forensic Science of CUPL, Beijing100088.

【Abstract】 Chapter VII of “Tort Liability Act”lefts some difficult issues, such as party selection , determination of cause of case, identifying standard of medical negligence and causation, property of medical record evidence , appraisal system and many other practical issues .To settle these Judicial practice issues, the Supreme People′s Court has now issued parts of judicial interpretations,, but all substantial issues have not been resolved yet . Since it takes time for the Supreme People′s Court to issue judicial interpretation, local Higher People′s Court can issue local judicial guidance documents for the judicial practice of the local specific situations prior to the Supreme People’s Court′s interpretation. Until now we know the four local trial guidance documents issued by Zhejiang , Jiangsu , Shanghai , Beijing, and these four cities or provinces have resolved some problems over compensation disputes for medical malpractice cases in local courts .These guidance documents are innovations in the system and with strong Operability.The introduction of guidance documents of local judicial trial not only solves the plight of compensation cases for medical damages in current local courts, but also accumulates experiences for the Supreme People′s Court for its legislating judicial interpretation.

【Key Words】 Compensation for medical malpractice ,Litigation, Difficult issues, Countermeasure