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医疗合同

(2007-05-23 20:45:13)
Second, the Netherlands Medical Services Act (Act on Medical Services)

——医疗合同有名化的样板-- Contract medical model of the famous

近年来,医疗过失责任在荷兰引起的纠纷迅速增加,而且人们付出的健康照护的成本也已经超过了社会所承认的限度。In recent years, medical malpractice liability in the Netherlands caused by the rapid increase in disputes. People pay and health care costs have already exceeded the community to acknowledge. [7]为了解决医疗关系中的纠纷,荷兰于1994年颁布了《医疗服务法案》(Act on Medical Services),该法案具体规定了病人在医疗关系中所享有的各项权利,以及可能导致医疗责任的各项侵权的情形。[7] In order to resolve medical disputes relations, the Netherlands in 1994, promulgated the "medical bills" (Act on Medical Services ), the bill specifies that the patients in the medical relations enjoyed by all rights, and may lead to the medical liability tort cases. 该法案于1995年被收入了《荷兰民法典》第七编“具体合同”之中,并易名为“医疗服务合同。”[8]荷兰立法上的这一做法区别于欧洲的其它国家将医疗关系推给法院解决的做法,目前在整个欧洲都是独一无二的。The bill revenue in 1995 was "the Dutch Civil Code," Title VII "specific contract", and renamed "medical services contract. "[8] The Dutch legislation on the practice distinct from the other European countries will be medical clearance to promoting the settlement of the court, in the whole of Europe is unique. 而荷兰立法者的这一举措产生于与产品责任的指令并行的欧洲致力于实现欧盟关于服务的指令,基于这一指令而规定进荷兰民法典第七编“具体合同”(the specific contracts)的还包括了分时享有合同(contract on time-sharing)和旅游合同(the travel contract)等。Dutch legislators and the initiatives arising from product liability directive of the European parallel commitment to the EU on the means Order Based on this Directive and the Dutch Civil Code provisions into Title VII, "the specific contract" (the specific cont racts) also enjoyed a time-sharing contract (contract on time-sharing ) and the tourism contract (the travel contract). [9]因此,这些做法也表明了荷兰立法者希望这部法典为欧州私法统一充当样板的愿望。[9] Thus, these practices also shows that the Dutch legislators hope that this Code of European Unification of Private Law as a model aspirations. [10][10]

荷兰争取病人权利的运动发端于1973年,由Jaap.Rang教授在Leiden大学发表的以“病人的权利”为主题的就职演说中提出。Netherlands for patients rights movement began in 1973, Jaap.Rang professor from the University of Leiden in the "patient's rights" as the theme of his inaugural speech raised. 这一行为促使荷兰政府开始考虑如何实现这些权利。This prompted the Dutch government to start considering how to achieve those rights. 在解决医疗纠纷的模式选择中,荷兰在合同模式和侵权(Negligence)模式之间选择了前者。在解决医疗纠纷的模式选择中, Dutch model of the contract and copyright infringement (Negligence) model chosen the former. 其主要原因在于,医患关系建立在患者自我决定(self-determination)的基础之上,而这一因素又被认为是病人和医生之间关系的基础因素。The main reason is that Doctor-patient relationship is built on patients self-determination (self-determination) basis, Also, and this is considered to be between patient and doctor relationship between the factors. [11]荷兰民法典的做法就是这一观念的明确体现。[11] Dutch Civil Code approach is the concept of clear expression. 必须注意的是,选择合同模式也存在一定的无法解决的困难,具体包括:第一,合同存在的基础在于对当事人缔约能力的肯定性评价,即先假定当事人具有“同意的能力”(capacity to consent),只有这样才有缔结合同的可能。It should be noted that the model contract options also exist some unsolved problems, specifically including : first, The contract is based on the ability of the contracting parties positive evaluation That is the assumption that the parties had "agreed that the" ability (capacity to consent). Only then would it be possible to conclude the contract. 但这种假定对于心智不全和处于昏迷状态的病人显然不能适用。But such assumptions for the mentally impaired and in a coma patients obviously not apply. 第二,合同的一方当事人难以确认。Secondly, a party to a contract difficult to confirm. 存在着对是病人还是病人的近亲属跟医院签订医疗合同的认定问题。The existence of the patient or the patient's close relatives, with the hospital signed a contract finds medical problems. 这是因为,在一般情况下,患者本人与医院之间签订医疗合同展开医疗关系并无疑义,但是在某些特殊情形中,如患者昏迷不醒。This is because, under normal circumstances, I patients between hospitals and medical contracts signed medical relationship has not carried out a doubt, However, in some special cases, such as patients became unconscious. 痴呆或者医疗合同也可以解释为一个第三人利益合同,病人可能只是一个受领给付的第三人,合同的真正双方当事人是其近亲属与医院。Dementia or medical contracts can also be interpreted as the interests of a third contract, patients may just receipt of a payment of a third person, the real contract parties is their close relatives and hospital. 第三,一个合同通常体现为双方当事人的确定的权利义务内容,但医疗合同却不具有这一特点,相比较而言,医疗合同更像单方事务(One-side affair)的确定,病人在这一合同中所负的义务包括合作、提供自身信息和支付报酬等内容,却享有与基本权相关的隐私权、同意权、查询治疗记录等重要权利。Third, the contract is usually a manifestation of the parties to determine the rights and obligations of the content, But in the contract does not have this characteristic, by contrast, like the unilateral contract medical services (One-side affair) the identification, Patients in the contract with its obligations, including co-operation to provide its own information and payment, enjoy basic rights and the right to privacy, consent, inquiries treatment records and other important rights. 基于此种认识,可以认为荷兰民法典对其冠以“医疗服务合同”是名副其实的,即无论是基于医疗行业的公益性质,还是基于医方所负义务的服务特征,医患之间的合同关系的确更像一种服务关系。Based on this understanding, that the Dutch Civil Code can be dubbed its "medical services contract" is truly, Regardless of the medical profession is based on the nature of the public interest, based on the medical side of the obligations of service, Doctor-patient relationship between the contract is more akin to a service relationship. 与其它解决医患纠纷的模式相比,合同模式具有的一个最大的优点在于,它建立在当事人意思自治的基础之上,这对于病人的某些权利,如知情权(the right of information)、同意权以及查阅记录的权利等,是一个非常自然的基础。And the other patient disputes settlement patterns, the contract with the model one of the biggest advantages is that it is based on party autonomy basis, which patients certain rights, If the right to know (the right of information). consent and the right of access to records, is a very natural foundation. 而如果依照现行的侵权模式,这些权利就很难得到实现。If, in accordance with the existing pattern of violations, these rights it will be very difficult to achieve. 对于上述有关采取合同模式所可能面临的问题,荷兰民法典也通过确立相应的条款予以克服For a contract above the model might face problems, the Netherlands Civil Code also through the establishment of the corresponding provisions be overcome

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