导　　师： 范利平

学科专业： 0301

授予学位： 硕士

作　　者： ;

机构地区： 广东外语外贸大学

摘　　要： 根据现行的《医疗事故处理条例》，医疗事故的处理途径有以下三种：当事人自行协商、卫生行政部门的调解以及法院诉讼。随着医疗纠纷的不断增加，现行医疗纠纷解决机制过于单一，不能满足纠纷的多样性以及患者对解决医疗纠纷高效率以及公正性的要求。为缓和医患矛盾，构建和谐医患关系，有必要创新医疗纠纷解决方式，发展和完善第三方调解机制，使其成为具有针对性的解决医疗纠纷有效平台。 医疗纠纷是一种具有很强专业性与高发性的特殊民事纠纷。其解决机制也应具有专业针和高效性。在现行医疗纠纷解决机制中，和解效率低下，卫生行政部门调解因其中立性遭质疑导致被边缘化，法院诉讼成本高昂等，都严重阻碍着医疗纠纷的有效解决。而第三方调解机制具有强专业性、低成本性、高效率性、普适应性等比较优势，成为医疗纠纷解决机制中的一种新兴方式。 我国对医疗纠纷第三方调解机制的研究尚处于摸索阶段，实践中各地纷纷试水，地方各自为阵，未在全国范围内形成统一的模式，理论研究也尚未有统一定论。通过总结归纳，得出我国第三方调解机制存在以下问题：一是第三方调解机构的权威性不够，二是第三方调解机构的中立性不足，三是第三方调解机制的经费缺乏保障，四是第三方调解机制的人才队伍建设不健全。围绕这些问题，运用理论研究与实证分析的方法，初步探索解决问题的出路。 对于调解机构的权威性问题，首先是明确第三方调解机构的法律地位，把其定位为医疗纠纷专业人民调解委员会，归属于“官办”与“民办”相结合的新时期人民调解委员会，可以依靠国家力量来保障其公信力。其次，通过规范设置第三方调解机构，把医疗纠纷专业人民调解委员会规定为司法行政部门牵头成立，和归口管理，并且通过设置规范的调解程序来予以保障。最后，对于其主持下所达成的调解协议，赋予民事合同的性质，通过司法确认和公证程序来保障其执行力。由此，从调解机构的规范性和调解协议的执行效力方面来提高调解机构的权威性。 对于调解机构的中立性问题，提出要在形式上和制度设计上来保障其中立性。即形式上要独立于卫生行政部门，程序上要充分尊重当事人自主权，把调解机构中立性放足于当事人控制最大化原则的制度保障中，弱化第三方调解机构的地位。对于调解机制的经费保障问题，采取依靠地方财政支持、依托医疗责任保险和社会捐助、公益赞助等社会途径来解决。对于调解机制的人才机制问题，则提出了要发展复合型人才培养，以及采用专兼职模式组建专家库，专职人员编制化来进行完善。 医疗纠纷第三方调解作为解纷机制的一种，有其他解决途径无法比拟的优势，但是其发展也存在着各种问题，机制尚不成熟。司法部强调医疗纠纷第三方调解机制的构建要符合区域差异化，不搞一刀切。笔者认为，在尊重区域化的前提下，努力寻求第三方调解机制成熟的发展模式，推动划一型的统一，以求规范，是第三方调解机制长足发展必然趋势。以此为目的，提高调解机构的权威性、中立性，完善调解机制经费保障和人才保障，使医疗纠纷第三方调解机制成为解决医疗纠纷的有效、高益平台。 In accordance with the medical malpractice bill,the calmed down of medicaldispute in our country at present contains three parts，self-negotiation,mediationpresided over Medical Administrative Command and litigation.With the increasingnumber of medical disputes, the current Control Mechanism is too single to meet thedemands of diversity, efficiency and fairness,making the conflict between the doctorand the patient becoming more and more seriously.Thus,it is necessary to develop theControl Mechanism toward Medical Dispute by the Third Party,to build a harmoniousrelationship. The medical dispute is a kind of special civil disputes,with high professinal andhigh risk,making its settlement mechanism professinal and efficent.In the currentmedical dispute settlement mechanism,there are advantages,namely the low efficiencyof conciliation,the lack of neutrality of mediation and the high-cost of litigation.Medical Dispute by the Third Party is becoming a new way,with its comparativeadvantages. There isn’t a conclusion on the research Control Mechanism toward MedicalDispute by the Third Party. Using the method of case analysis to summarize, itscurrent situation and problems can be drawed in the following aspects: lack ofauthority, lack of neutral, lack of funds and lack of talents. On this basis,suggestionsto the involved problems are available. To improve the authority,firstly,define the legal status of the third partymediation as professinal medical dispute mediation committee,a kind of the people'sMediation Committee combinaed by official and private. Secondly, set up thestandard of its building,which is set and controled by the judicial and administrativedepartments.In aditional,set up a series of mediation procedures in scientific andresonable as safeguardence. Finally,take the mediation agreement as a contract,withexecution via judicial confirmation and notarization procedures. To make sure the neutrality,it should be independent from the administrativedepartment of public health in the form and design the system adhere to the maximumcontrol of parties in program.For financial security,it can be mainly supported by localfinacial,medical liability insurance and social donations.On the talent,put forward todevelop compound talents training and build the expert database in the model of part-time and full-time. The Control Mechanism toward Medical Dispute by the Third Party is only alink of dispute-solving mechanism. The variety and complexity of dispute require theresources of solving dispute should be rich enough.Because of the comparativeadvantages over other dispute solutions,it plays an important role to build a multiplemechanism for solving the medical dispute.In respect of regional,promoting a unifiedtype of Control Mechanism toward Medical Dispute by the Third Party is the comingtendency.

关 键 词： 医疗纠纷 第三方调解 权威性 中立性

分 类 号： [D922.16]

领　　域： [政治法律] [政治法律]