日本医疗纠纷防范处理措施研究

日本的人文以及社会文化背景与我国相近,而日本医院精细化的管理,医师协会创立的医疗责任保险以及有效的医疗纠纷处理机制,使得日本的医疗纠纷发生率一直较低.通过分析日本在防范医疗纠纷中以上几方面的成功经验,提出对我国医疗纠纷防范的启示,为我国当前医疗纠纷的防范和处理提供有益的参考.     

医疗纠纷的法治反思

21世纪以来,非法治思维和非法治方式在我国医疗纠纷处理中盛行。原因主要有政府未能及时回应医疗纠纷立法的价值取向冲突、医疗纠纷非诉讼处理途径不畅、打击"医闹"软弱乏力、建立城乡居民医疗保险和医疗责任保险制度较晚、未能对医疗卫生提供适当的经费投入、未能合理规划医疗资源和全面推行分级诊疗、患方信闹不信法、医方推诿不守法、司法公信力和权威性不强。建议以法治思维和法治方式处理医疗纠纷,政府要全面加强和推进医疗纠纷处理的职责履行,医患双方要依法预防和处理医疗纠纷,司法机关要强化司法公信力和权威性。     

论当前医疗纠纷的表现特点,处理及防范对策

报道本教研室４３年３１６例医疗纠纷尸检资料的分析结果,结合实际工作经验与体会,论述当前医疗纠绿的表现特点,处理对策和防范措施。认为近年来医疗纠纷逐渐增多;发生科室以妇产科和外科多见;医疗纠纷中非医疗事故多于医疗事故。处理对策建议是：遵循法律,注意程序,讲究方法,公平合理。指出完善医疗管理是防范医疗纠纷的关键,提高医疗水平是防范医疗纠纷的根本。     

论医疗责任保险的外部条件

推广医疗责任保险是近年来卫生领域的一项重要政策。但是迄今的运行实践表明,医疗责任保险有名无实,既不能有效减轻医疗机构的负担,也不能对医疗纠纷的解决发挥预期作用。从美国与德国在医疗责任保险实施效果上的严重反差来看,医疗责任保险的推行,需要有完善的法制与社会保障制度作为支撑。未来应当将医疗责任保险与医疗意外保险同步推行,建立特殊的医疗风险社会保障制度,减轻患者的经济负担,才可能实现医疗责任保险的良好运行。     

基于相互制医疗责任保险思考医疗纠纷解决机制

符合医疗行业特点的保险模式和制度设计是医疗责任保险制度成功的关键。与商业性的责任保险相比,相互制医疗责任保险具有成本低、减少信息不对称以及风险控制和维护行业利益等多方面的优势。相互制医疗保险制度的构建应当在组织构成和保单条款等方面符合其相互性特点和医疗行业的实际需要。相互制医疗保险组织在分散医疗机构责任风险的同时,应当代替医疗机构全面介入医疗纠纷解决过程,从而提高解决医疗纠纷的质量和效率,促进医患关系的和谐。     

南宁市医患双方对医疗纠纷第三方调解认知状况调查

为了解医患双方对医疗纠纷第三方调解认知状况,对南宁市4家医院的医务人员和患者进行问卷调查,并运用描述性分析、卡方检验等统计学方法进行数据分析。调查显示,39.7%的调查对象对医疗纠纷第三方调解不了解;58.7%的调查对象认为第三方调解只可以解决小部分纠纷;35.2%的调查对象最看重第三方调解的中立性;48.7%的医务人员希望能节省费用;47.4%的患者希望可以减少信息不对称;45.2%的调查对象认为医疗责任保险的重要性不大。提出加大宣传力度、加强立法与监督、培养有资质的调解员以及建立强制性医疗责任保险制度等对策。     

内蒙古某市医疗纠纷现状分析

提高医疗质量,改善医患关系,防范医疗纠纷是当前医疗机构关注的热点.如何掌握医疗纠纷的发生规律,探讨当前医疗纠纷增多的原因,寻找有效的控制手段,公正合理地处理医疗纠纷,以保持社会的稳定显得尤为重要和迫切.现将内蒙古某市医学会自2002年9月以来受理的65例医疗纠纷鉴定情况进行整理分析,从医疗事故技术鉴定的角度探讨医疗事故、医疗过错发生的原因及防范对策,从而进一步规范医疗行为,提高医疗质量.     

内蒙古某市医疗纠纷现状分析

提高医疗质量,改善医患关系,防范医疗纠纷是当前医疗机构关注的热点。如何掌握医疗纠纷的发生规律,探讨当前医疗纠纷增多的原因,寻找有效的控制手段,公正合理地处理医疗纠纷,以保持社会的稳定显得尤为重要和迫切。现将内蒙古某市医学会自2002年9月以来受理的65例医疗纠纷鉴定情况进行整理分析,从医疗事故技术鉴定的角度探讨医疗事故、医疗过错发生的原因及防范对策,从而进一步规范医疗行为,提高医疗质量。2002年9月~2006年2月内蒙古某市医学会受理的医疗纠纷全部案例,依据《医疗事故处理条例》、《医疗事故技术鉴定暂行办法》中的鉴定工作程…     

某综合医院医疗纠纷数据分析及原因初探

分析某综合医院医疗纠纷发生的特点及原因,提出防范医疗纠纷的建议。对该院2010年~2013年医疗纠纷的数量、科室分布、原因构成、患者分布特征及其采取的主要行为、处理途径与结果等进行描述性分析。外科科室是医疗纠纷发生的高发科室;医疗技术水平、服务水平是导致该院发生医疗纠纷的主要原因;医患纠纷频数与患者文化程度有一定相关度;医疗纠纷主要在医院内进行沟通解决。通过提高医疗服务质量、强化医疗纠纷高发科室的监管、加强医患间的有效沟通等途径防范医疗纠纷。     

从医疗纠纷看病案的质量问题

病案既是医疗行为的唯一载体,也是医疗保险理赔、损伤和伤残鉴定及医疗事故处理的重要法律依据,又是证明医疗行为正确与否的重要证据.但是,目前我国各级医疗机构中病案管理和书写均存在着一定的质量问题,这不仅容易直接导致医疗纠纷,也给解决医疗纠纷和司法鉴定带来一定困难,同时在一定程度上也给医疗纠纷中的被告--医方带来不利.<医疗事故处理条例>中明确规定,"医疗机构无正当理由未按规定如实提供相关病历资料,导致医疗事故技术鉴定不能进行的"即存在举证不能、举证不力的应承担责任[1].因此,加强病案管理,规范病案书写,提高医务人员的病案管理意识,对防范和解决医疗纠纷具有重要的意义.现就内蒙古某市医学会在医疗纠纷技术鉴定中,发现病案中存在的质量问题及防范对策简述如下.     

Wittgenstein and the Dualism of the Inner and the Outer

A dualism characteristic of modern philosophy is the conception of the inner and the outer as two independently intelligible domains. Wittgenstein’s attack on this dualism contains deep insights. The main insight (excavated from §304 and §293 of the Philosophical Investigations) is this: our sensory consciousness is deeply shaped by language and this shaping plays a fundamental role in the etiology of the dualism. I locate this role in the learning of a sensation-language (as described in §244), by showing that this learning is, under another aspect, the incision of language, namely the infliction of cuts upon certain natural-primitive unities between the inner and the outer. These cuts, driven by powerful forces, eventually harden into an entrenched division between the inner and the outer, thereby providing a constant soil for the dualism. That this dualism is rooted in the very learning of a language is cause for ambivalence about language.     

Peter McHugh and Analysis: The One and the Many, the Universal and the Particular, the Whole and the Part

This paper takes the passing of Peter McHugh as an occasion to examine the intellectual development of his work. The paper is mainly focused on the product of his collaboration with his colleague and friend, Alan Blum. As such, it addresses the tradition of social inquiry, Analysis, which they cofounded. It traces the influence of Harold Garfinkel’s Ethnomethodology on McHugh and on the beginning of Analysis. The collaboration with Blum is examined through a variety of coauthored works but most especially in the two books On the Beginning of Social Inquiry (1974) and Self Reflection in the Arts and Sciences (1984). It also examines the relation of his independent writing before 1974, and since 1984 to the expression of the tradition of inquiry as exemplified in those two texts. The paper builds on some interview material with Peter McHugh and reflects on the influence of Peter the teacher as well as the theorist McHugh. Most especially, through its engagement with this material, it seeks to exemplify the dialectic and living nature of the program called Analysis.     

Yin and Yang,and the Hot and the Cold

Yin and Yang are important concepts in ancient Chinese philosophy.Western scholars have become more familiar with these two concepts recently,but for a long time almost no one considered comparing them with their own tradition such as the ancient Greek philosophy,and especially with the ideas of the Hot and the Cold in Presocratic philosophy.In this paper,I make an attempt to do exactly that,and especially make a detailed comparison between the thoughts of two ancient thinkers:Laozi and Anaximander.I discuss the thought of Yin and Yang in Laozi-who was the earliest philosopher making use of the concepts Yin and Yang-to express his cosmological thought in ancient Chinese philosophy.Comparatively,I discuss the ideas of the Hot and the Cold in Anaximander,the earlier among Presocratic philosophers referring to the Hot and the Cold as fundamental concepts used to establish his cosmological system.Through this comparison,I indicate that the similarity between ancient Chinese and Western traditions is far more significant than what people are used to imagining.     

经济全球化与东西方宗教

本文认为,由于科技的高度发展,信息网络技术的普及,经济全球化已成为不可逆转的发展趋势;而经济全球化必然带来东西方宗教的种种变化。作者从传统宗教的复兴、民族宗教的冲突、宗教与政治的结缘。宗教的普世化与本色化、新兴宗教的异军突起及东西方宗教的交流与融合等６个方面分析了当前东西方宗教的这种发展趋势。     

Glossolalia and the psychology of the self and narcissism

A survey of the religious and psychological literature on glossolalia (speaking in tongues) reviews the various ways that have been used to try to understand this fascinating practice. At the present time an impasse has been reached: glossolalists can no longer be viewed as suffering from psychopathological disorders or from sociological deprivation. Insights derived from the psychology of the self and narcissism, as presented in the works of Heinz Kohut and D.W. Winnicott, are used to suggest new approaches to understand glossolalia.     

Belief and the problem of Ulysses and the sirens

While self-contained, this paper is a sequel to my Belief and the Will (1984); see theBibliographical Note at the end of this paper for a survey of the relevant literature since then and supplementary references. I have meanwhile benefitted greatly from Brad Armendt's commentary and Richard Foley's How should future opinion affect current opinion?, both presented at a symposium at the APA Central Division, April 1993.     

Spontaneity and Self-Consciousness in the Groundwork and the B-Critique

ABSTRACT

According to some influential readings of the Groundwork of the Metaphysics of Morals, the view presented there of the kind of spontaneity we are conscious of through theoretical reason and the significance of such self-consciousness is irremediably at odds with the Critical theory, and thus roundly and rightly rejected in the second edition of the Critique of Pure Reason and the Critique of Practical Reason. This paper argues, on the contrary, that the Groundwork can be read as articulating for the first time the account of self-consciousness and spontaneity that Kant goes on to develop in the B-Critique, especially the B-Transcendental Deduction.