国家卫健委、司法部联合发文:以后发生这种医疗纠纷,医院不再担责!

2018-10-15 杨瑞静 健康界综合

10月11日,国家卫生健康委和司法部起草了《医疗损害鉴定管理办法(征求意见稿)》(下称《管理办法》),统一医疗损害鉴定制度管理要求。

10月11日,国家卫生健康委和司法部起草了《医疗损害鉴定管理办法(征求意见稿)》(下称《管理办法》),统一医疗损害鉴定制度管理要求。


这才是医疗损害鉴定的真面目

医疗损害鉴定,是指医疗损害鉴定机构组织相应专家,对委托人提交的医患双方因诊疗活动引发的争议中是否存在医疗过错、患者的损害后果、医疗过错行为与医疗损害后果是否存在因果关系、医疗过错行为在医疗损害后果中的责任程度等专门性问题进行专业技术判断,并向委托人提供鉴定意见的活动。

按照《医疗纠纷预防和处理条例》规定,医疗损害鉴定,作为诉讼前鉴定,不属于司法鉴定。

《管理办法》指出,医疗损害鉴定应当坚持科学性、公正性、同行评议的原则。医疗损害鉴定机构收费应当注重社会公益性,鉴定费预先向医患双方收取,最终按照责任比例承担。

医疗损害鉴定,医学会准备好了吗?

全国绝大多数医学会仅仅开展了医疗事故技术鉴定,没有开展医疗损害责任技术鉴定。无论是医患双方,还是法院,多倾向于选择委托司法鉴定机构进行医疗损害鉴定。《管理办法》则打破医学会和司法鉴定机构之间的壁垒,医患双方可以在医学会和司法鉴定机构之间进行选择。

《管理办法》明确,从事医疗损害鉴定业务的医学会应当是省级医学会或者设区的市级医学会。

同时符合条件的医学会和司法鉴定机构应当在开展首例医疗损害鉴定之日起5个工作日内同时向所在地省级卫生、司法行政部门备案。

公婆都有理,我该听谁的?

医学问题兼具复杂性与专业性,医疗损害鉴定结果能一个人说了算?为提高鉴定意见的科学性和公信力,《管理办法》提出建立医疗损害鉴定专家库。

《管理办法》指出,设区的市级卫生、司法行政部门应当共同设立市级医疗损害鉴定专家库,省级专家库由本行政区域内各市级专家库组成,国家专家库由各省级专家库组成。

医疗损害鉴定专家库应当包含医学、法学、法医学等领域的专家,并成立专家库管理办公室,具体职责由医学会承担。

《管理办法》强调,从医疗损害鉴定专家库中抽取专家时,应当优先选择鉴定机构所在地市级医疗损害鉴定专家库中的专家。医疗纠纷人民调解委员会调解医疗纠纷时,可以从医疗损害鉴定专家库中选取专家咨询。

这才是完整的鉴定过程

按照《管理办法》的要求,一次完整的鉴定实施过程应当是这样的。

医疗损害鉴定机构应当组织符合条件的鉴定人员组成人数为3人或3人以上单数的鉴定专家组,并根据医疗损害争议所涉及的学科专业和鉴定事项的复杂程度,确定鉴定专家组人数和学科专业组成。最终,鉴定专家组应当合议作出鉴定意见。

医疗损害鉴定一般应当组织召开鉴定陈述会。鉴定专家组认为不需要的,可以不召开陈述会。

《管理办法》指出,医疗损害鉴定机构应当在受理鉴定之日起30个工作日内完成鉴定,制作并保存医疗损害鉴定档案,档案保存期为10年。

医疗损害鉴定,不是你想做就能做!

为了避免造成社会资源浪费,想做医疗损害鉴定也是有条件的。

《管理办法》指出,在医疗纠纷处理过程中,遇有以下情形可以进行医疗损害鉴定:

(一)医患双方对医疗损害责任有分歧,对医疗纠纷的解决不能达成一致意见的;

(二)预计赔付金额数额较大的;

(三)委托人或者医患双方认为需要鉴定的;

(四)法律、法规、规章规定的其他情形。

为避免多次重复鉴定影响鉴定公信力,一般只能做一次鉴定;不得不重新鉴定时,《管理办法》规定,应当委托原医疗损害鉴定机构以外的其他鉴定机构进行。接受重新鉴定委托的医疗损害鉴定机构条件应当不低于原鉴定机构。

别害怕!发生了这种事,医院不承担责任!

当鉴定为患者有损害时,医院就要百分之百负责任吗?不是。《管理办法》强调,患者有损害,因下列情形之一的,医疗机构不承担医疗损害责任。

(一)患者或者其近亲属不配合医疗机构进行符合诊疗规范的诊疗

(二)医务人员在抢救生命垂危的患者等紧急情况下已经尽到合理诊疗义务;

(三)限于当时的医疗水平难以诊疗。

前款第一项情形中,医疗机构及其医务人员也有过错的,应当承担相应的责任。

如果出现医疗过错行为,医院要如何承担责任?《管理办法》指出,医疗过错行为在医疗损害后果中的责任程度应当根据造成患者损害的原因力大小确定,原因力可按具体情形表述为全部原因、主要原因、同等原因、次要原因、轻微原因、无因果关系。

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    2018-10-16 ewsr5
  5. [GetPortalCommentsPageByObjectIdResponse(id=1258451, encodeId=110c125845187, content=<a href='/topic/show?id=b0ae365e02f' target=_blank style='color:#2F92EE;'>#卫健委#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36570, encryptionId=b0ae365e02f, topicName=卫健委)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=医者仁心, createdTime=Tue Oct 16 15:00:00 CST 2018, time=2018-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1291104, encodeId=361a129110463, content=<a href='/topic/show?id=e53140859f6' target=_blank style='color:#2F92EE;'>#国家卫健委#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40859, encryptionId=e53140859f6, topicName=国家卫健委)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Tue Oct 16 15:00:00 CST 2018, time=2018-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1402139, encodeId=758b1402139ff, content=<a href='/topic/show?id=310a35124e9' target=_blank style='color:#2F92EE;'>#医疗纠纷#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=35124, encryptionId=310a35124e9, topicName=医疗纠纷)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f6f2387781, createdName=yyanpro@22cn.c, createdTime=Tue Oct 16 15:00:00 CST 2018, time=2018-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1536432, encodeId=cf10153643207, content=<a href='/topic/show?id=c054e70973c' target=_blank style='color:#2F92EE;'>#纠纷#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77097, encryptionId=c054e70973c, topicName=纠纷)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74d012693594, createdName=ewsr5, createdTime=Tue Oct 16 15:00:00 CST 2018, time=2018-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=349398, encodeId=177534939849, content=医院不给转院坚持自己手术出事了能算第三条吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d74d2455467, createdName=12403636m23暂无昵称, createdTime=Mon Oct 15 08:21:52 CST 2018, time=2018-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=349371, encodeId=fe8f3493e170, content=你说的是真的, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM5Jh3ibfGBfIVfM2miakkANh4Jo9NNRpiaJf2B5vq1BnerymzyUahsgEGicWQpmQ4FTyM4aKkqF0hdfgrnzMPdd0ujRm0ickARtWlKM/0, createdBy=60cf2013095, createdName=zhp0142536, createdTime=Mon Oct 15 07:17:23 CST 2018, time=2018-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=349367, encodeId=fda634936ec0, content=谢谢分享,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Mon Oct 15 07:09:32 CST 2018, time=2018-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=349355, encodeId=788634935547, content=谢谢了,学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Mon Oct 15 04:55:00 CST 2018, time=2018-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=349354, encodeId=d4e334935407, content=厉害了我的妹, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Mon Oct 15 00:41:26 CST 2018, time=2018-10-15, status=1, ipAttribution=)]
    2018-10-15 12403636m23暂无昵称

    医院不给转院坚持自己手术出事了能算第三条吗

    0

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    2018-10-15 zhp0142536

    你说的是真的

    0

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    2018-10-15 明月清辉

    谢谢分享,学习了

    0

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    2018-10-15 txqjm

    谢谢了,学习

    0

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    2018-10-15 飛歌

    厉害了我的妹

    0

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