發(fā)布時間：2018-03-23 04:00

  本文選題：實習醫(yī)師　切入點：醫(yī)療行為　出處：《南京大學》2014年碩士論文　論文類型：學位論文

【摘要】：醫(yī)療行業(yè)因其本身具有高度的專業(yè)性和風險性,對從事醫(yī)療行業(yè)的醫(yī)務人員有著更加嚴格的專業(yè)要求。然而,醫(yī)務人員的培養(yǎng)是一個循序漸進的過程,在取得正式的執(zhí)業(yè)資格之前,實習醫(yī)師是任何一名合格的執(zhí)業(yè)醫(yī)師都必須經(jīng)歷的階段。實習醫(yī)師雖在醫(yī)療機構工作,因其未取得執(zhí)業(yè)資格不能獨立實施醫(yī)療行為,但可以在執(zhí)業(yè)醫(yī)師的指導下實施醫(yī)療行為,從而積累臨床經(jīng)驗。實習醫(yī)師身份的特殊性使其無法完全履行醫(yī)師的職責。實習醫(yī)師具有身份上的模糊性,就診人員無法準確知悉實習醫(yī)師與執(zhí)業(yè)醫(yī)師的不同,從而造成實習醫(yī)師違規(guī)行醫(yī)的現(xiàn)象時有發(fā)生。我國目前還未有專門的法律對實習醫(yī)師違規(guī)行醫(yī)進行法律規(guī)制,在實習醫(yī)師違規(guī)行醫(yī)造成就診人損害發(fā)生后,實習醫(yī)師因主體身份的特殊性無法一概認定為醫(yī)療侵權也不能全以非法行醫(yī)造成損害加以法律規(guī)制根據(jù)法律規(guī)定。實習醫(yī)師不得獨立實施醫(yī)療行為,其所有醫(yī)療行為需在執(zhí)業(yè)醫(yī)師的指導監(jiān)督下方可進行。實習醫(yī)師作為執(zhí)業(yè)醫(yī)師培養(yǎng)的必經(jīng)階段也可以在執(zhí)業(yè)醫(yī)師指導下從事醫(yī)療行為,具有一定的專業(yè)素養(yǎng),但因其臨床經(jīng)驗不夠,不足以取得執(zhí)業(yè)資格,故其無法完全履行執(zhí)業(yè)醫(yī)師義務,對其違規(guī)行醫(yī)造成損害的,一般有兩種觀點：其一,以醫(yī)療損害責任加以規(guī)制；其二,以非法行醫(yī)行為加以規(guī)制。通過北大醫(yī)療事故一案看來,外界對實習醫(yī)師違規(guī)行醫(yī)行為存在認識偏差,只要實習醫(yī)師造成損害結果發(fā)生的一概以非法行醫(yī)論之,然而事實并非如此。本文從臨床實際出發(fā),以實習醫(yī)師違規(guī)行醫(yī)為探討對象,在闡述了一般性的醫(yī)學概念后,主要從實習醫(yī)師違規(guī)行醫(yī)的責任認定和責任承擔兩個主要方面對實習醫(yī)師違規(guī)行醫(yī)進行侵權法上的分析論述,從而確定實習醫(yī)師違規(guī)行醫(yī)后法律責任的承擔。根據(jù)有無醫(yī)療機構授權,實習醫(yī)師違規(guī)行醫(yī)一般有以下兩種情形：1.醫(yī)療機構授權下的實習醫(yī)師違規(guī)行醫(yī),2.無醫(yī)療機構授權實習醫(yī)師擅自違規(guī)行醫(yī)。雖然該兩種情形下對認定實習醫(yī)師違規(guī)行醫(yī)造成損害的責任認定并無實質(zhì)的區(qū)別,但在法律責任承擔上卻大有不同,前者是由醫(yī)療機構承擔損害賠償責任,而后者則是由實習醫(yī)師本人承擔損害賠償責任。只要責任主體確定,具體的責任承擔方式皆可按照相關法律規(guī)定加以確定,從而保障受害人的利益。本文撰寫的主要目的是為了分析實習醫(yī)師違規(guī)行醫(yī)現(xiàn)象產(chǎn)生的原因,從法律層面上找出相應的對策,規(guī)范實習醫(yī)師的臨床培養(yǎng),逐漸減少甚至杜絕違規(guī)行醫(yī)現(xiàn)象的再發(fā)生；加強相關法制宣傳教育,提升廣大人民群眾對實習醫(yī)師培養(yǎng)的理解和認同感,從而建立和諧的醫(yī)患關系。
[Abstract]:Because of its high degree of professionalism and risk, the medical industry has more stringent professional requirements for the medical personnel engaged in the medical profession. However, the training of medical personnel is a gradual and gradual process. Before obtaining a formal practice qualification, a trainee is a stage that any qualified medical practitioner must go through. Although the intern works in a medical institution, he or she cannot independently carry out a medical act because he is not qualified to practise. However, medical practice can be carried out under the guidance of a medical practitioner, thus accumulating clinical experience. The particularity of the identity of an intern makes him unable to fully perform his duties as a physician, and the intern has the ambiguity of identity. The doctor can not know exactly the difference between the intern and the medical practitioner, which results in the phenomenon that the intern violates the practice of medicine from time to time. At present, there is no special law to regulate the illegal practice of the intern in our country. After an intern who violates the practice of medical treatment causes damage to the doctor, Because of the particularity of the subject identity, interns can not always be recognized as medical tort, nor can they be completely regulated by the law as a result of damage caused by illegal medical practice, and according to the provisions of the law, interns are not allowed to carry out medical acts independently. All its medical activities can only be carried out under the guidance and supervision of the medical practitioner. Interns, as a necessary stage of training, can also engage in medical behavior under the guidance of the medical practitioner and have a certain degree of professional accomplishment. But because its clinical experience is not enough, not enough to obtain the profession qualification, therefore it is unable to fulfill the practice doctor's duty completely, causes the harm to its illegal practice medicine, generally has two kinds of viewpoint: first, with the medical treatment damage responsibility to regulate; second, According to the case of medical malpractice at Peking University, the outside world has a bias in understanding the illegal practice of medicine, so long as the result of injury caused by the intern is discussed as illegal practice. However, it is not the case. This article, based on the clinical practice, takes the practice of medical practice as the object of discussion, after expounding the general concept of medicine, Mainly from the two main aspects of the responsibility and responsibility of practicing medicine illegally, the author analyzes and discusses the tort law of the illegal practice of medical practice by interns. In order to determine the legal liability of interns after practicing medicine illegally. According to the authorization of medical institutions, There are generally two situations in which interns practice illegally under the authority of medical institutions. 2. No medical institution authorizes interns to practice medicine without authorization. There is no material difference between the determination of liability for damage caused by medical practice, However, the legal liability is quite different. The former is for the medical institution to bear the liability for damages, while the latter is for the intern himself to bear the liability for the damage. As long as the subject of the responsibility is determined, Specific ways of assuming responsibility can be determined in accordance with relevant laws and regulations to protect the interests of the victims. The main purpose of this article is to analyze the causes of the phenomenon of interns practicing medicine illegally. Find out the corresponding countermeasures from the legal level, standardize the clinical training of interns, gradually reduce or even eliminate the recurrence of illegal medical practice, strengthen the relevant legal publicity and education, To promote the understanding and identity of the masses of the masses on the training of interns, thus to establish a harmonious relationship between doctors and patients.
【學位授予單位】：南京大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：D922.16

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