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中南大学学报(社会科学版)
ZHONGNAN DAXUE XUEBAO(SHEHUI KEXUE BAN)

2020年03月第26卷第2期
   
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文章编号:1672-3104(2020)02-0056-13
 
侵害患者知情同意权的司法认定与裁判路径——基于222份民事裁判文书的分析
 
宋宗宇,丁磊
 
(重庆大学法学院,重庆,400044)
 
摘  要: 对近年来侵害知情同意权案件进行分析后发现,法院对责任构成要件的认定存在较大出入。为准确区分医疗伦理损害责任与医疗技术损害责任,应按以下路径裁判:其一,以取得患者同意为依据判断违法行为,患者对此承担举证义务;其二,适用过错推定责任,遵循损害、因果关系、违法行为、过错依次判断的顺序;其三,采纳合法替代行为抗辩理论,采用以同意为基础的法律因果关系判断方法;其四,违反“知情同意”原则是对身体权的损害,侵害不真正意思决定机会不是侵权责任法保护范畴,不应支持精神损害赔偿。《医疗损害责任解释》第5、11、17条分别存在违反逻辑改变举证责任、鉴定范围认识不清、权利性质判断不当等问题,应予修改。
 
关键词: 患者知情同意权;违法行为;过错推定;法律因果关系;精神损害
 
 
Judicial determination and judgment path of infringing patients' rights of informed consent: Based on analysis of 222 civil judgments
 
SONG Zongyu, DING Lei
 
(School of Law, Chongqing University, Chongqing 400044, China)
 
Abstract: The results of analyzing infringement cases of informed consent in recent years show that the courts have greater discrepancies in the identification of the elements of responsibility. In order to accurately distinguish the responsibility of medical ethical damage and medical technology damage, the following path should be used. Firstly, the patient’s consent is used to judge the illegal behavior, and the patient has the burden of proof. Secondly, the presumption of fault liability should be applied according to the judgment order of damage, causality, illegal behavior and fault. Thirdly, the theory of legal alternative behavior defense should be adopted to establish a legal causality judgment method based on consent. Fourthly, violation of the principle of “informed consent” is a damage to the autonomy of the body,Infringement does not really mean that the opportunity to decide is not the scope of protection of the tort liability law and should not support compensation for moral damage. Articles 5, 11 and 17 of Interpretation of the Supreme People's Court on Several Issues respectively have problems in violating the logic to change the burden of proof, unclear understanding of the scope of the identification and improper judgment of the nature of rights, and therefore should be amended.
 
Key words: patients' rights of informed consent; illegal behavior; fault presumption; legal causation; mental damage
 
 
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