法官一般不懂医学,对于医疗纠纷中的专业性问题难以把握,在诉讼中很难形成自己的内心确信,因此只能高度依赖医疗损害鉴定。医疗损害鉴定意见甚至可以左右一场医疗纠纷诉讼的成败,因而被称为医疗纠纷诉讼的“准判决书”。然而,我国现有的医疗损害鉴定体制弊端重重,被社会广为诟病,成为制约我国医疗纠纷诉讼的一个瓶颈问题。一、问题:医疗损害鉴定的二元体制2010年7月,最高人民法院发布《关于适用<侵权责任法>若干问题的通知》(以下简称《通知》)。《通知》指出,人民法院适用《侵权责任法》审理民事纠纷案件,根据当事人的申请或者依职权决定进行医疗损害鉴定的,按照《全国人大常委会关于司法鉴定管理问题的决定》、《人民法院对外委托司法鉴定管理规定》及 Judges, who generally do not understand medicine, find it difficult to grasp the professional problems in medical disputes and can hardly form their own inner conviction in litigation so that they can only rely highly on the identification of medical damages. Medical damage identification opinion may even affect the success or failure of a medical dispute litigation, which is called the medical dispute litigation “quasi-verdict ”. However, the existing medical malpractice appraisal system in our country has many drawbacks and is widely criticized by the society, which has become a bottleneck problem that restricts medical dispute litigation in our country. I. Issue: Binary System for Medical Damage Identification In July 2010, the Supreme People’s Court issued the Notice on Several Issues Concerning the Application of Tort Liability Law (hereinafter referred to as the “Notice”). According to the “Notice”, according to the People’s Courts’ application of the Tort Liability Law for trial of civil disputes and the determination of medical damages according to the application of the parties or according to their functions and powers, the People’s Court, in accordance with the Decision of the NPC Standing Committee on the Administration of Judicial Appraisals, Foreign commissioned forensic management regulations "and