美國醫療糾紛仲裁發展困境的緣由與中國的選擇

Reasons for the Development Predicament of Arbitration for Medical Malpractice in U. S. and China's Option

為緩解醫患矛盾、妥善解決醫療糾紛，我國學界和實務界都大力宣導醫療糾紛仲裁制度。美國聯邦和州立法機關及法院40多年的努力，並未改變因醫療事故危機而被青睞的醫療糾紛仲裁40多年的坎坷發展。醫療糾紛仲裁的優勢未必可靠、醫生的抵制、原 告的抵觸和挑戰、不能克服訴訟的缺陷以及撤銷期間的規定和不同仲裁模式的選擇，都在某種程度上阻礙了醫療糾紛仲裁的發展。我國醫療糾紛同樣面臨患者的不信任感、醫療過錯判定的悖論和醫療行為的特性以及自願性仲裁與強制性仲裁各有缺陷的現實，這就決定了我國並不適合採納醫療糾紛仲裁制度。醫療糾紛仲裁難以擔當緩解醫患矛盾、解決醫鬧問題的重任，很可能淪為變相的調解。

To mitigate the contradiction and handle the disputes between the hospitals and patients, the theoretical research and practical profession both advocate arbitration system for medical disputes. The forty years' endeavor made by the legislation and courts both in federal and state level in U. S. didn't change the forty years' tough development of the arbitration system which was favored due to the medical malpractice crisis. The development of the arbitration on medical malpractice is, to some extent, impeded by the unreliability of the advantages of arbitration on medical malpractice, the resistance by the doctor, the conflict and challenge from the plaintiff, incapability to overcome the defect of litigation, regulation for revocation period and option for arbitration model. Similarly, medical malpractice disputes are faced with the unreliability of the patients, the paradox of the judgment of medical malpractice, the characteristic of medical behavior and the respective defect of the voluntary arbitration and mandatory arbitration, which determines that it is not appropriate to adopt arbitration for medical malpractice in China. Arbitration for medical malpractice can't assume the great responsibility to mitigate the contradiction, handle the medical disturbance and may become mediation in disguise.