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我国《侵权责任法》开始施行后,其关于医疗事故举证责任分配的规定引起了各方的关注。与以往长期适用的《最高人民法院关于民事诉讼证据的若干规定》相比,新规定明确了医疗纠纷案件中医疗机构替代责任的性质是过错侵权责任,并仅在例外情况下推定医疗机构存在过错,否则应由患者承担证明医疗机构及其医务人员存在过错的责任。本文探讨了《若干规定》与《侵权责任法》不同举证责任分配背后的价值考量,比较了医患双方的获得证据能力、运用医学知识证明能力,考察了司法实践中还原案件事实、降低诉讼成本的要求,并结合实践中存在的困境,得出推定侵权责任在当前阶段不应被抛弃、过错和因果关系要件的举证责任倒置尚有存在必要的结论。本文亦就当前适用新规定的情况下,应当采取何种方式手段才可能保护患者的正当权益提出了意见。
After China’s “Tort Liability Law” came into force, its provisions on the distribution of the burden of proof in medical accidents aroused the attention of all parties. Compared with the long-standing “Certain Provisions of the Supreme People’s Court on Evidence in Civil Litigation,” the new Provisions make it clear that the nature of the alternative liability of medical institutions in medical disputes is a fault of tort and only prejudice the existence of a fault in medical institutions in exceptional cases , Otherwise the patient should bear the burden of proving the existence of fault in medical institutions and their medical personnel. This paper explores the value considerations behind the different burden of proof in the “Several Provisions” and the “Tort Liability Law”, compares the ability of both doctors and patients to obtain evidence, and uses the medical knowledge to prove the ability, examines the fact of restoring the case in judicial practice and reduces the cost of litigation In the light of the difficulties existing in practice, it is concluded that the assumption of the tort liability should not be abandoned at this stage, and the burden of proof on the fault and the causality is still inverted. In this article, we also put forward some suggestions on what ways and means should be adopted to protect the legitimate rights and interests of patients under the current situation of applying the new regulations.