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1、第二十一章第二十一章醫(yī)療糾紛與醫(yī)療事故醫(yī)療糾紛與醫(yī)療事故教學(xué)綱要教學(xué)綱要教學(xué)要求：教學(xué)要求：1.1.掌握：掌握：醫(yī)療糾紛的概念與特點(diǎn)；醫(yī)療事故的概念與構(gòu)成的條件；醫(yī)療糾紛的類型和發(fā)生原因；醫(yī)療事故的類型和發(fā)生的原因；法醫(yī)在醫(yī)療糾紛和醫(yī)療事故鑒定中的作用；法醫(yī)尸體解剖在醫(yī)療糾紛處理中的作用；非法行醫(yī)的概念與常見類型。2.2.熟悉：熟悉：醫(yī)療事故的分級(jí)；醫(yī)療糾紛或醫(yī)療事故的處理程序；鑒定及鑒定程序；醫(yī)療糾紛法醫(yī)病理學(xué)鑒定注意事項(xiàng)。3了解：了
2、解：醫(yī)療糾紛和醫(yī)療事故民事責(zé)任的確定；醫(yī)療糾紛和醫(yī)療事故行政責(zé)任的確定；醫(yī)療糾紛中的刑事責(zé)任。【教學(xué)內(nèi)容】第一節(jié)概述一、醫(yī)療糾紛的概念與特點(diǎn)二、醫(yī)療事故的概念與構(gòu)成條件第二節(jié)醫(yī)療糾紛與醫(yī)療事故的類型和發(fā)生原因一、醫(yī)療糾紛的類型和發(fā)生原因二、醫(yī)療事故的類型和發(fā)生原因三、醫(yī)療事故的分級(jí)第三節(jié)醫(yī)療糾紛與醫(yī)療事故的責(zé)任類型一、醫(yī)療糾紛或醫(yī)療事故民事責(zé)任的確定二、醫(yī)療糾紛或醫(yī)療事故行政責(zé)任的確定三、醫(yī)療糾紛中的刑事責(zé)任第四節(jié)醫(yī)療糾紛或醫(yī)療事故的處
3、理與鑒定一、醫(yī)療糾紛或醫(yī)療事故的處理程序too.OnJune21999Italysciviljusticesystemrevertedtoatwotrackprocedure.Italyprovidesnolegalaidmostcasesofallegedmedicalnegligencearepursuedviathecriminalcourtsatnocosttotheclaimant.Alternativedisputereso
4、lutionisseeingsomegrowth.CivilprocedureFclaimantswhocanaffdcivillitigationtherearenoparticularregulationsprotocolsthatmightdeliverafastefficienteffectiveeconomicalservice.Theprocesscanbeslowbureaucraticsomecasestakingman
5、yyearstocometotrial.TheCodiceCivileregulatestherelationsbetweendoctpatientbutwithrulesapplicabletoanyintellectualprofession.Befe1995therewereonlytworoutesthePreturatheTribunale(sittingwiththreemagistrates).Thenathreetrac
6、ksystemwasestablishedtospeedupciviljusticeinamannersimilartotherecentWoolfrefmsintheUK.1Thesystemaimedtoallocatecasesappropriatelytooneofthreetracksattemptedtointroducesomerulesguidelinesftheactivemanagementofeachparticu
7、larcase.Thethreetrackswere:thegiudicedipace(ajusticeofthepeaceoftenalawyer)thepreteajudgesittingalonethetribunalecivilewiththreejudgesfmecomplexcases.Thegiudicedipacelargelyachievedtheobjectivesofspeedingupproceedingssot
8、hatclaimsupto5millionlire(￡1700)couldbeheardwithinayear.Doctsspecialisinginmedicallawwereoftencalledtoestimatedamages.Thepreteheardcasesupto30millionlire(￡10000).Againtheproptionofcasesdealtwithinlessthanayearincreasedsi
9、gnificantlybetween19951999.Claimantdefendantcalledexpertsthejudgecalledhisownmedicolegalcourtappointeddoctspecificexperts.Themedicolegaldoctwasaskedtogivehisopinionofcurrentbestpractice.HoweverthiswasnottheBolamstardwher
10、ethedoctisjudgedagainstthereasonableacceptablepracticeofthetime(notbestpractice).Decidingwhatcontemparybestpracticeiscanbedifficultenoughitisevenmedifficulttosaywhatbestpracticewasatthetimeoftheeventcomplainedof.Thispret
11、elevelwasabolishedfromJune1999.ThetwotracksystemintroducedinJunelastyearretainsthegiudicedipacebutthetribunalsnowsitwithasinglejudge.Havingonejudgeinsteadofthreereducesthetimetakenfcasestocometocourtthecostofindividualca
12、ses.Toaccessthenewsystemapatientseekingcompensationviatheciviljusticesystemusuallyhastogetasecondopinionfromanotherconsultantfromthespecialistmedicolegaldoct(seebelow)toestablishwhethernotthereisaprimafaciecaseofnegligen
13、ce.Withinthecivilsystemproblemsremaindespitetherecentchanges.Thereisnostrictcasemanagementvastnumbersofexpertsmaybecalledtheabsenceoflegalaidpromptsclaimantstopursuedoctsviathecriminalrouteleadingtocriminalgesguiltyverdi
14、ctsonoccasionprisonsentencesthestardofproof(“bestpractice”)hasyettobedefinedinItalianlawtheroleofthemedicolegaldoctisparamount.Themedicolegaldoctisaspecialisttrainedinmedicinelaw.Heshewilloftenbeappointedbythecourtwillha
15、veadutytothecourtadvisingthecourton“bestpractice”.Thisadvicecanbedifficultsincetherewillbeexpertsftheclaimantfthedefencefromdifferentschoolsofthought.Medicolegaldoctsmayalsocalltheirownexpertstosupptaparticularviewofbest
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