现行医疗损害鉴定制度的反思与重构

摘要

对医疗损害鉴定采用何种模式,理论界分歧甚大,上海、江苏等地方高院与最高人民法院的观点也存在差异.从实证分析看,鉴定结论的轻重、当事人的选择倾向、判决的采纳与否都并非鉴定是否可信的决定因素.可信鉴定模式的自在要素在于科学性与公正性,其中科学性来自鉴定人的专业性,公正性来自程序的正当性.在鉴定体制重构选择上应该:新建全国统一的鉴定专家库成本过高;司法鉴定模式科学性先天不足,制度改建困难;医学会鉴定模式能保障鉴定主体的适任,其在程序上的缺陷可借鉴上海等地的做法通过规定有限异地鉴定、鉴定人出庭等进行修正.%There are many different views about which mode of medical harm identification is suitable. Science and fairness, rather than severity of the identification conclusions, select tendency of the parties or acceptation in the judgment determine the credibility of the medical damage identification according to empirical research. Furthermore, scientific comes from the apprais-ers' professional and fairness derives from the legitimacy of identification program. Experts are competent while the programs have some shortcomings in medical association identification mode, and it should be amended according to the experience of Shanghai to stipulate identification in different places under certain circumstances, identification of person in court, and etc.