發(fā)布時間：2018-06-10 16:23

  本文選題：醫(yī)療行為 + 過失�。� 參考：《華東政法大學(xué)》2014年博士論文

【摘要】：從刑法史學(xué)的角度來考察對重大醫(yī)療過失過失行為的刑法規(guī)制，相關(guān)立法可謂歷史久遠(yuǎn)，上溯到公元前18世紀(jì)，古巴比倫的《漢謨拉比法典》就已經(jīng)有了相關(guān)規(guī)定，而我國《唐律疏議》則最早規(guī)定了醫(yī)療過失犯罪，此后歷代相沿，直至清末修律。晚近以來，醫(yī)療過失犯罪研究一直是德日為主大陸法系刑法的重要分支——醫(yī)事刑法學(xué)的重要內(nèi)容，英美法系也不排除重大醫(yī)療過失行為的刑事責(zé)任。本文在對兩大法系的代表國家刑事醫(yī)療過失理論研究和司法實踐的成果充分比較和借鑒的基礎(chǔ)上，通過實證研究指出我國刑事醫(yī)療過失立法與司法的困境，積極構(gòu)建我國的刑事醫(yī)療過失研究的理論體系，以期更好的完善相關(guān)刑事政策、立法和司法。 除了導(dǎo)論以外，本文共分為五章，分別為醫(yī)療行為的考察與概覽，刑事醫(yī)療過失的理論基礎(chǔ)和實證分析，刑事醫(yī)療過失的因果關(guān)系與責(zé)任分配，醫(yī)療過失刑民邊界之厘清，醫(yī)療過失刑事政策、立法與司法完善。 導(dǎo)論部分分別就刑事醫(yī)療過失問題研究的緣起、研究現(xiàn)狀、研究的方法和本文的主要觀點進(jìn)行了闡述。研究的緣起主要從歷史、現(xiàn)狀和未來闡明研究重大醫(yī)療過失行為刑法規(guī)制的重要意義。通過比較和分析，指出我國刑事醫(yī)療過失研究的不足。希望通過對刑事醫(yī)療過失系統(tǒng)化的研究，從而在理論和實踐上彌補這一領(lǐng)域的缺憾。 第一章“醫(yī)療行為的考察與概覽”。本章是本文的破題所在，同時也是本文研究的理論前提和邏輯起點，共分為三節(jié)。第一節(jié)主要界定醫(yī)療行為的概念與特征。厘清醫(yī)療行為概念的內(nèi)涵和外延，是醫(yī)療過失行為的違法性判斷的前提和基礎(chǔ)。本節(jié)分別考察了中國古代、臺灣地區(qū)、日本對醫(yī)療行為的學(xué)理和實踐中的概念，并一一回應(yīng)了醫(yī)療行為目的、行為主體、行為對象、行為的危險性等國內(nèi)外理論爭議的焦點。筆者提出了廣義和狹義的醫(yī)療行為概念與分類方法，提出醫(yī)療行為主體的特定性、目的的正當(dāng)性、行為的業(yè)務(wù)性、醫(yī)療手段的傷害性、醫(yī)療水平的適切性和行為效果的有限性特征；第二節(jié)闡述了醫(yī)學(xué)倫理發(fā)展對醫(yī)療行為的影響，生命科技與醫(yī)學(xué)模式的改變給現(xiàn)代刑法帶來的諸多問題和挑戰(zhàn)。提出了法律不應(yīng)該是科學(xué)技術(shù)的旁觀者，而應(yīng)成為科學(xué)技術(shù)不誤入歧途的引路人，應(yīng)加大對新興科技犯罪及重大過失犯罪的懲罰力度；第三節(jié)主要圍繞兩大法系理論上長期存在爭議的醫(yī)療行為“傷害說”和“非傷害說”，進(jìn)行了系統(tǒng)的歸納和評述，提出我國應(yīng)堅持醫(yī)療行為“傷害說”的理由和根據(jù)，以及當(dāng)下科技發(fā)展、醫(yī)學(xué)模式更迭和醫(yī)療信息化背景下的刑法應(yīng)對。 第二章“刑事醫(yī)療過失的理論基礎(chǔ)和實證分析”。本章是構(gòu)建本文理論脈絡(luò)的依據(jù)和事實基礎(chǔ)。 第一節(jié)首先確定刑事醫(yī)療過失作為業(yè)務(wù)過失犯的本質(zhì)，進(jìn)而從各國的法律規(guī)范和學(xué)理研究，探討其作為業(yè)務(wù)過失犯的屬性和特征，通過對過失犯、業(yè)務(wù)過失犯概念的梳理和厘定，從而確立刑事醫(yī)療過失的概念和內(nèi)容，以及肯定其作為業(yè)務(wù)過失犯應(yīng)較普通過失加重處罰的依據(jù)，并結(jié)合案例具體闡述了臨床上造成重大醫(yī)療過失常見的醫(yī)療行為的樣態(tài)。駁斥了醫(yī)療過失“刑事豁免”理由，提出對重大醫(yī)療過失的刑法規(guī)制的必然性和謙抑性；第二節(jié)主要介紹醫(yī)療過失刑事立法。本節(jié)選取兩大法系代表國家和地區(qū)醫(yī)療過失的刑事立法現(xiàn)狀和趨勢，系統(tǒng)了回顧了我國歷史上醫(yī)療過失犯罪立法的演進(jìn)與嬗變，以及現(xiàn)行刑法第335條專設(shè)醫(yī)療事故罪的由來與發(fā)展；第三節(jié)主要是針對我國1997年醫(yī)療事故罪設(shè)立以來刑事判例的實證分析，系統(tǒng)闡述了醫(yī)療事故罪立法和司法面臨的困境。 第三章主要闡述“刑事醫(yī)療過失中的因果關(guān)系與責(zé)任分配”。本章重點介紹了刑事醫(yī)療過失因果關(guān)系的特點、刑事醫(yī)療過失因果關(guān)系的判斷和醫(yī)學(xué)鑒定對醫(yī)療因果關(guān)系的影響以及對醫(yī)療過失刑事責(zé)任分配進(jìn)行了闡述。 第一節(jié)闡述了刑事醫(yī)療過失因果關(guān)系的特點；第二節(jié)闡述刑事醫(yī)療過失因果關(guān)系的判斷。重點闡述了大陸法系“因果關(guān)系條件說”、“相當(dāng)因果關(guān)系說”在刑事醫(yī)療過失中具體適用，及論證疫病學(xué)因果關(guān)系在刑事醫(yī)療過失中的可采性；第三節(jié)闡述了刑事醫(yī)療過失鑒定在因果關(guān)系判定中的地位和作用。分析域外兩大法系關(guān)于刑事醫(yī)療過失鑒定的主要經(jīng)驗、我國二元制鑒定模式的成因和困境，提出了刑事醫(yī)療過失的判斷應(yīng)以醫(yī)療事故鑒定為主和積極構(gòu)建我國刑事醫(yī)療過失鑒定制度的構(gòu)想；第四節(jié)“醫(yī)療過失刑事責(zé)任的分配”，主要以危險分配理論為基礎(chǔ)，探討在刑事醫(yī)療過失領(lǐng)域被允許的危險法理、危險分配理論、信賴原則、監(jiān)督過失理論及其適用，為恰當(dāng)?shù)南蘅s醫(yī)療過失的刑事責(zé)任提供理論依據(jù)。 第四章“醫(yī)療過失刑民邊界之厘清”。本章主要從刑法中的二次違法理論和刑法第335條醫(yī)療事故罪的構(gòu)成要件，從法規(guī)范的角度探討醫(yī)療過失的刑民邊界之所在，為刑事責(zé)任判斷提出標(biāo)準(zhǔn)。 第一節(jié)重點闡述醫(yī)療過失刑民邊界的法律依據(jù)。本文認(rèn)為醫(yī)療過失的刑民邊界的法律基礎(chǔ)在于現(xiàn)行刑事和民事立法，系統(tǒng)回顧了我國醫(yī)療過失刑事和民事立法的演進(jìn)及兩者的主要區(qū)別；第二節(jié)重點闡述在現(xiàn)行刑法第335條的框架下，探討醫(yī)療過失刑民邊界的分野。分別從損害事實分野、違法行為的邊界和主觀罪過的邊界進(jìn)行了厘定；第三節(jié)主要從經(jīng)濟(jì)學(xué)視角闡述醫(yī)療過失的刑民邊界。本文借用漢德公式從經(jīng)濟(jì)學(xué)視角分析注意義務(wù)與成本之間的關(guān)系，分析經(jīng)濟(jì)學(xué)上刑民過失的邊界之所在；第四節(jié)從醫(yī)療過失中常見的造成患者死亡或重傷、但不應(yīng)當(dāng)承擔(dān)刑事責(zé)任的情形進(jìn)行了歸納和排除。 第五章“醫(yī)療過失刑事政策、立法與司法完善”。本章重點介紹了對各國醫(yī)療過失犯罪刑事政策的考察，提出了我國醫(yī)療過失刑事政策的應(yīng)對，以及完善我國醫(yī)療過失刑事立法與司法的建議。 第一節(jié)介紹了對各國醫(yī)療過失刑事政策的考察。本文通過對兩大法系代表國家的刑事政策的考察，認(rèn)為目前世界各國對重大醫(yī)療過失刑事政策趨于嚴(yán)厲，對于醫(yī)療新技術(shù)的刑事政策因利益考量多有反復(fù)，并分析了我國惡性醫(yī)療糾紛不斷增多的原因；第二節(jié)關(guān)于我國醫(yī)療過失刑事政策的應(yīng)對。本文同意李斯特“最好的社會政策就是最好的刑事政策說”，提出應(yīng)從強化刑法的預(yù)防功能、重建醫(yī)療道德秩序、刑事責(zé)任主體適度擴張和完善醫(yī)療保障制度、完善醫(yī)療損害的救濟(jì)途徑等五個方面進(jìn)行應(yīng)對；第三節(jié)提出了完善我國醫(yī)療過失的刑事立法和司法建議。本文主張廢棄專設(shè)罪名的立法模式，在“侵害公民人身權(quán)利、民主權(quán)利”一章，設(shè)立業(yè)務(wù)過失犯罪，在立法上統(tǒng)一該類犯罪的刑法規(guī)制。即便保留專設(shè)罪名，也應(yīng)冠之以“重大醫(yī)療過失罪”，并歸入“侵害公民人身權(quán)利、民主權(quán)利”一章，，增加法人犯罪的規(guī)定。關(guān)于刑事醫(yī)療過失鑒定制度，建議設(shè)立兩級體系，在省級醫(yī)療事故鑒定委員會的框架下設(shè)刑事醫(yī)療鑒定委員會；關(guān)于醫(yī)務(wù)人員違反注意義務(wù)的標(biāo)準(zhǔn)，本文主張吸收“醫(yī)療水平論”，即以當(dāng)時之醫(yī)療水準(zhǔn)為判斷注意義務(wù)的標(biāo)準(zhǔn)。法條修正應(yīng)該提高法定最高刑、增設(shè)罰金刑和資格刑，罪狀應(yīng)修改為：“醫(yī)務(wù)人員嚴(yán)重違反注意義務(wù)或偏離醫(yī)療水準(zhǔn)，導(dǎo)致就診人死亡或者重傷的，處五年以下有期徒刑或者拘役，單處或并處罰金。單位犯前款的，對于單位判處罰金，并對直接負(fù)責(zé)的主管人員和其他直接責(zé)任人員，依照前款處罰�！�
[Abstract]:From the perspective of the history of criminal law, the criminal law regulation of major negligence in medical negligence is examined. The relevant legislation is a long history. It has been traced to the eighteenth Century B.C., the Cuban code of Hammurabi, Cuba, has related provisions, and the "Tang law" in our country first stipulates the crime of medical negligence, followed by the subsequent dynasties until the end of the Qing Dynasty. Since late, the study of medical negligence crime has been an important part of the criminal law of medical affairs, which is an important branch of the criminal law of the civil law of the mainland of Germany and Japan. The common law system does not exclude the criminal responsibility of the major medical negligence. The results of this paper are fully compared to the results of the theoretical research and judicial practice of the two major legal systems. On the basis of the reference, through empirical research, it points out the dilemma of criminal medical negligence legislation and judicature in our country, and actively constructs the theoretical system of criminal medical negligence research in our country, in order to better improve the relevant criminal policy, legislation and judicature.
In addition to the introduction, this article is divided into five chapters, which are the investigation and survey of medical behavior, the theoretical basis and empirical analysis of criminal medical negligence, the causal relationship and responsibility distribution of criminal medical negligence, the clarification of the border of medical negligence, the criminal policy of medical negligence, the establishment of law and the perfection of the judicature.
The introduction part expounds the origin of the study of criminal medical negligence, the present situation, the method of research and the main points of this article. The origin of the study is mainly from the history, the status quo and the future to clarify the significance of the criminal regulation of major medical negligence. Through comparison and analysis, the study of criminal medical negligence in China is pointed out. In order to make up for the defects in this field, we hope to make a systematic study of criminal medical negligence.
The first chapter is the theoretical premise and logical starting point of this article, and it is divided into three sections. The first section mainly defines the concept and characteristics of medical behavior. The definition and extension of the concept of medical behavior is the premise and basis of the illegality judgment of medical treatment negligence. This section examines the concepts of the theory and practice of medical behavior in ancient China, Taiwan, and Japan, and responds to the focus of theoretical disputes at home and abroad, such as the purpose of medical behavior, the subject of behavior, the object of behavior, the danger of behavior, and the author puts forward the concept and classification method of medical behavior in the broad and narrow sense, and puts forward the medical treatment. The specific character of the subject, the justification of the purpose, the business of the behavior, the harm of the medical means, the appropriateness of the medical level and the limited characteristics of the effect of the behavior; the second section expounds the influence of the medical ethics development on the medical behavior, the changes of the life science and technology and the medical model to the many problems and challenges brought by the modern criminal law. The law should not be a spectator of science and technology, but should be a guide for science and technology, and should increase the punishment of new science and technology crime and major negligence crime. The third section focuses on the system of "injury theory" and "non injure", which have been disputed for a long time in the two legal systems. The reasons and bases for the "injure theory" of medical behavior, as well as the current scientific and technological development, medical model change and the criminal law under the background of medical information should be put forward and reviewed.
The second chapter is the theoretical basis and empirical analysis of criminal medical negligence.
The first section first determines the essence of criminal medical negligence as the criminal of business negligence, and then discusses the attributes and characteristics of criminal negligent offense from the legal norms and academic studies of various countries. By combing and defining the concept of negligent offense and business negligence, the concept and content of criminal medical negligence are established, and it is affirmed as the industry. The crime of negligent offense should be heavier than ordinary negligence, and the cases of medical negligence which cause major medical negligence are explained in detail. The reason for the "criminal exemption" of medical negligence is refuted, the necessity and modesty of the criminal law regulation of major medical negligence are put forward. The second section mainly introduces the medical negligence punishment. This section selects the status and trend of the two legal systems to represent the criminal legislation of medical negligence in the state and region, systematically reviews the evolution and evolution of the legislation of the medical negligence crime in the history of our country, and the origin and development of the 335th articles in the current criminal law for medical accidents. The third section is mainly aimed at the crime of medical accidents in China in 1997. The empirical analysis of criminal precedents has systematically expounded the predicament faced by legislation and judicature of medical malpractice crime.
The third chapter mainly expounds the causality and responsibility distribution in criminal medical negligence. This chapter focuses on the characteristics of the causality of criminal medical negligence, the judgment of the causality of criminal medical negligence and the influence of medical identification on the medical cause and effect, and the distribution of the criminal responsibility of medical negligence.
The first section expounds the characteristics of the causal relationship between criminal negligence and negligence; the second section expounds the judgment of the causality relationship in criminal medical negligence. It focuses on the "causation condition theory" in the continental law system, the specific application of "the equivalent causality theory" in the criminal medical negligence, and the demonstration of the possibility of the causal relationship in the criminal medical negligence in the criminal medical negligence. The third section expounds the position and function of the criminal medical negligence identification in the determination of causality. It analyzes the main experience of the two major legal systems in the field of criminal medical negligence identification, the causes and difficulties of the two yuan system identification model in China, and puts forward that the judgment of the criminal medical negligence should be based on the identification of medical accidents and the construction of our country punishment actively. The fourth section of "the distribution of criminal liability for medical negligence", based on the theory of dangerous distribution, discusses the permissible legal theory, the theory of risk distribution, the principle of trust, the theory of Supervision Negligence and its application, and provides the appropriate criminal liability for the limitation of medical negligence. Theoretical basis.
The fourth chapter is "the clarification of the boundary of the criminal negligence of the people". This chapter mainly from the two illegal theories of the criminal law and the constituent elements of the 335th medical accident crimes in criminal law, and from the angle of law to discuss the location of the border of the criminal negligence of medical negligence, and put forward a standard for the judgment of criminal responsibility.
The first section focuses on the legal basis of the boundary of the criminal negligence of the people. This article holds that the legal basis of the criminal and civil boundary of the medical negligence lies in the current criminal and civil legislation, and systematically reviews the evolution of the criminal and civil legislation of medical negligence in China and the main differences between the two; the second section expounds the framework of the 335th article of the current criminal law, The division of the boundary of the criminal negligence of the medical negligence is discussed. The boundary of the violation of the facts, the boundary of the illegal act and the boundary of the subjective crime are determined respectively. The third section mainly expounds the boundary of the criminal people of the medical negligence from the economic perspective. The fourth section, which is common in medical negligence, causes death or serious injury in medical negligence, but it should not be summed up and excluded from the case of criminal responsibility.
The fifth chapter "criminal policy of medical negligence, legislation and judicial perfection". This chapter focuses on the investigation of the criminal policy of medical negligence in various countries, and puts forward the Countermeasures of the criminal policy of medical negligence in China, and the suggestions for perfecting the criminal legislation and judicature of medical negligence in China.
The first section introduces the investigation of the criminal policy of medical negligence in various countries. Through the investigation of the criminal policy of the two legal systems representing the country, it is believed that the criminal policy of major medical negligence tends to be severe in the world at present, and the criminal policy of the new medical technology is repeated because of its interest, and the malignant medical disputes in our country are analyzed. The second section about the criminal policy of medical negligence in China. This article agrees that Lester's "best social policy is the best criminal policy". It is proposed that the prevention function of the criminal law should be strengthened, the medical moral order should be rebuilt, the subject of criminal responsibility should be properly expanded and perfected the medical security system, and the medical damage should be perfected. In the third section, we put forward the criminal legislation and judicial suggestions to improve the medical negligence in our country. This article advocates the abolition of the legislative mode of the specific crime, the chapter of "infringing on the rights of citizens, democratic rights", establishing business negligence crime and unifying the criminal law of this kind of crime on the legislative basis, even if it is reserved. Special charges should also be called "crime of major medical negligence", and belong to the chapter "infringement of the personal rights of citizens, democratic rights" and the provision of legal person crime. On the criminal medical negligence identification system, a two level system is proposed to establish a criminal medical appraisal committee under the framework of the Provincial Medical Accident Identification Committee; In violation of the standard of duty of attention, this article advocates the absorption of "the theory of medical treatment", that is, the standard of paying attention to the duty of attention at the level of medical treatment at that time. The amendment of the law should increase the maximum penalty, increase the penalty and the qualification penalty, and the crime should be amended as: "medical staff Yan Zhongwei's anti attention obligation or deviation from the medical standard, leading to the doctor. If a person is dead or seriously injured, he shall be sentenced to fixed-term imprisonment of not more than five years or criminal detention. The preceding paragraph of the unit shall be fined, and the person directly in charge and other persons directly responsible shall be punished in accordance with the preceding paragraph. "
【學(xué)位授予單位】：華東政法大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2014
【分類號】：D924.3

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相關(guān)期刊論文 前10條

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