———以《中华人民共和国侵权责任法》第 58 条为视角

谷佳杰

【摘 要】 证明妨碍行为在医疗损害赔偿诉讼中大量存在，特别是控制有绝大多数证据材料的医疗机构一方如果实施证明妨碍行为，将对处于弱势地位的患者的合法权益造成极大损害。我国的《侵权责任法》已经出现了医疗损害赔偿诉讼的证明妨碍制度。证明妨碍的法理基础不仅包括诚实信用原则和武器平等原则，同时应在立法中明确一方当事人的证明权或对方的诉讼协力义务。由于患者存在举证困难、证明责任转换制度不足和医患双方武器不平等，证明妨碍在医疗诉讼中的适用具有很强的现实必要性。医疗损害赔偿诉讼中证明妨碍的构成要件包括了主观要件和客观要件。至于法律效果，《侵权责任法》只规定了推定主张成立，还应当赋予法院进行证明度降低和证明责任转换的权力。

【关键词】 证明妨碍；法理基础；必要性；构成要件；法律效果

【中图分类号】 D918.9

【文献标识码】 A

【文章编号】 1674-1226（2013）02-0248-09

On the application Spoliation of Evidence in the Medical Compensation Claims for Damages -- from the perspective of Article 58 of China’s Tort Liability Law. Gu Jiajie,

【Abstract】 There are a lot of spoliations of evidence in the medical malpractice compensation proceedings.Especially, if the medical institutions that control the vast majority of evidentiary materials obstruct the evidence,the legitimate interests of the disadvantaged patients will be damaged. There has been the system of spoliation of evidence regarding the medical claim for damages in Chinese Tort Liability Law. Its legal basis should include not only the good faith doctrine and the principle of equality of arms in civil proceedings, but also the duty of cooperation and the right of proof. Because of the difficulty in providing evidences by patient, the deficiency of shifting the burden of evidence and the inequality of arms between medical institutions and patient, it is greatly necessary to apply the spoliation of evidence to medical actions. There exist subjective elements and objective elements in its constitutive requirements. With regard to the legal effect, the Tort Liability Law only exists assuming the truth,and should provide the court with the power of reducing the degrade of proof and shifting the burden of proof.

【Key Words】 Spoliation of evidence，Legal basis，Necessity，Constitutive requirements，Legal effects