Measures for the prevention and treatment of medical disputes in Fujian Province
Chapter I General Principles
Article 1 In order to effectively prevent and deal with medical disputes, protect the legitimate rights and interests of patients, medical institutions and their medical staff, maintain medical order and build a harmonious doctor-patient relationship, these Measures are formulated in accordance with relevant national laws and regulations and combined with the actual situation of this province.
Article 2 Medical disputes as mentioned in these Measures refer to disputes caused by medical activities between both parties.
Article 3 These Measures shall apply to the prevention and treatment of medical disputes within the administrative area of this province.
Article 4 The handling of medical disputes shall follow the principles of legality, fairness, timeliness and convenience for the people, with clear facts, accurate qualitative analysis, clear responsibilities and proper handling.
Article 5 The people's governments at or above the county level shall strengthen their leadership in the prevention and handling of medical disputes, incorporate the prevention and handling of medical disputes into the comprehensive management system of social security, establish a "five-in-one" working mechanism for the prevention and handling of medical disputes with "communication and mediation in hospitals, emergency linkage, third-party mediation of medical disputes, medical liability insurance and medical assistance" as the main contents, coordinate and solve major problems in the prevention and handling of medical disputes, and urge relevant departments to perform their duties according to law.
The township people's government (street office), village (neighborhood) committees and relevant units where the medical institution is located, the patient's domicile or residence shall cooperate with relevant departments to prevent and handle medical disputes.
Article 6 The administrative department of health and family planning of the people's government at or above the county level shall guide and supervise medical institutions to do a good job in the prevention and handling of medical disputes according to law, and deal with responsible medical institutions and their medical personnel according to law.
Article 7 The judicial administrative department of the people's government at or above the county level shall strengthen the guidance on the people's mediation of medical disputes and promote the standardization of the people's mediation of medical disputes.
Article 8 The public security organs of the people's governments at or above the county level shall maintain the public order of medical institutions according to law, supervise and guide medical institutions to implement internal public security work, and investigate and deal with illegal and criminal acts that infringe on the personal and property safety of medical personnel and patients and disrupt the order of medical institutions according to law.
Article 9 The departments of finance, civil affairs, price, letters and visits of the people's governments at or above the county level shall do a good job in the prevention and handling of medical disputes according to their respective duties.
Insurance supervision and management institutions shall, in accordance with the relevant provisions of the state, supervise and manage insurance institutions to regulate medical liability insurance and medical accident insurance business.
Article 10 The news media should abide by relevant laws and regulations, abide by professional ethics, advocate civilized, harmonious and mutual trust between doctors and patients, report medical disputes objectively, comprehensively and truly, and correctly guide public opinion.
Citizens, legal persons or other organizations shall abide by relevant laws and regulations and take facts as the basis when making statements related to medical disputes.
Eleventh to establish a people's mediation system for medical disputes. City and county (District) shall set up a People's Mediation Committee for Medical Disputes (hereinafter referred to as the Medical Mediation Committee) to be responsible for the people's mediation of medical disputes within their respective administrative areas.
The medical commission does not charge any fees to the parties for mediating medical disputes. The daily office space, working funds and subsidies of the people's mediators of the Medical Commission shall be guaranteed by the finance at the same level.
Twelfth establish and improve the social medical assistance mechanism. After handling medical disputes, patients whose family economic conditions meet the conditions of social assistance may apply to the Township People's Government (street offices) for social assistance.
Chapter II Prevention
Article 13 The health and family planning administrative department of the people's government at or above the county level shall guide medical institutions to establish and improve the early warning mechanism of medical disputes and the consultation and communication mechanism between doctors and patients, standardize the access of medical institutions, medical personnel and medical technology according to law, strengthen the supervision and management of medical institutions and their medical personnel's practice behavior, medical technology use and medical equipment configuration, and urge and guide medical institutions to improve service quality and medical level.
Article 14 Medical institutions should strengthen the education and training of medical personnel's business and professional ethics, improve the communication ability between doctors and patients, establish and improve the medical quality monitoring and evaluation system, the medical safety responsibility system and the fault accountability system, and improve the medical quality management and control system.
Article 15 Medical institutions shall establish and improve the system for handling medical disputes, formulate plans for the prevention and handling of medical disputes, clarify the responsibilities of the heads of medical institutions, departments and medical personnel in handling medical disputes, standardize the procedures for handling medical disputes, regularly analyze the causes of medical disputes, and prevent the occurrence of medical disputes.
Sixteenth medical institutions should establish and improve the consultation and communication mechanism between doctors and patients, clarify the consultation and complaint management department, set up a reception place, and be equipped with full-time (part-time) staff to accept patients' consultation and complaints. Announce the methods and procedures for resolving medical disputes and the responsibilities, addresses and contact information of relevant institutions such as the Medical Commission in a prominent position in medical institutions.
Seventeenth medical institutions and their medical personnel shall abide by the following provisions in medical activities:
(a) abide by the laws, regulations, rules, norms and practices of medical and health management, and abide by the professional ethics of medical services;
(2) Care, love and respect patients and protect their privacy;
(three) due to illness, reasonable treatment;
(four) truthfully inform the patient's condition, medical measures, medical risks, medical expenses, etc. And answer their inquiries in time, and do a good job of psychological counseling. Truthfully inform the patient that there may be adverse consequences, and truthfully inform his close relatives;
(five) the need for surgery, special examination, special treatment, experimental clinical treatment, it shall obtain the written consent of the patient or his near relatives;
(6) If the opinions of patients and their close relatives cannot be obtained due to emergency situations such as rescuing dying patients, corresponding medical measures can be implemented immediately with the approval of the person in charge of the medical institution or the authorized person in charge;
(seven) in accordance with the provisions of the state to write and save medical records. Due to the rescue of critically ill patients, the medical records cannot be written in time, and the relevant medical personnel shall supplement the facts within 6 hours after the rescue, and make records.
Eighteenth medical personnel shall not have the following acts in medical activities:
(a) in violation of the norms and routine of diagnosis and treatment, the implementation of unnecessary inspection;
(two) the use of diagnosis and treatment techniques, drugs and medical devices that are not suitable for the condition;
(3) Tampering, forging, concealing, destroying or discarding medical records;
(4) accepting property from the parties concerned or seeking other illegitimate interests.
Article 19 The affected party shall abide by the following provisions:
(1) Abide by the management system and medical order of medical institutions and respect medical personnel;
(two) truthfully state the medical history to the medical staff, cooperate with the medical staff for examination, diagnosis and care, and sign the relevant informed consent written materials as required;
(3) Paying medical expenses according to regulations;
(four) to cooperate with medical institutions to arrange referral or discharge according to their requirements;
(five) have objections to medical behavior, express opinions and demands according to law.
Patients shall not force medical institutions to do medical acts beyond their treatment ability and scope of practice.
Article 20 Patients have the right to consult, copy or duplicate the temperature list, doctor's orders, hospitalization records (admission records), operation consent, anesthesia consent, anesthesia records, operation records, nursing records of patients with severe (critical) diseases, discharge records, informed consent for blood transfusion treatment, consent for special examination (special treatment), pathological reports, inspection reports and other aids.
Subjective analysis of medical records such as course records, case discussions and consultation opinions does not belong to the category that patients can copy or duplicate.
Public security, justice, insurance and departments responsible for technical appraisal of medical accidents shall, due to the need of handling cases, carry out professional technical appraisal and commercial insurance audit according to law. , request to consult or copy medical records. After providing relevant certification materials, medical institutions can provide part or all of the patient's medical records as needed.
Twenty-first patients in accordance with the provisions of article twentieth request to copy or duplicate medical records, medical institutions should provide copying or copying services, and affix the seal of proof on the copied or duplicated medical records. When copying or duplicating medical records, patients should be present.
If the patient requests to copy or duplicate the medical record, he can copy or duplicate the completed medical record first, and then copy or duplicate the newly completed part after the medical staff completes the medical record according to the regulations.
Article 22 The public security organ shall establish a working mechanism for the prevention and disposal of medical disputes, information sharing and rapid response to police situations with the health and family planning administrative departments and medical institutions within its jurisdiction.
The public security organs set up police offices in tertiary hospitals, and all hospitals above secondary level patrol. Conditional can be set up in the surrounding police room or set up a public security booth. Medical institutions shall provide office space and related facilities for the police.
Twenty-third public security organs shall, in accordance with the provisions, report qualified medical institutions within their jurisdiction to the people's government at the same level as key units of public security, and guide and urge medical institutions to implement public security preventive measures.
Medical institutions should implement the responsibility system for public security work within their units, strengthen the construction of "civil air defense, physical defense and technical defense" and improve the public security prevention and control system.
Chapter III Disposal
Section 1 General Provisions
Twenty-fourth people's governments at or above the county level shall establish a diversified medical dispute mediation mechanism.
After a medical dispute occurs, both parties can choose the following ways to solve it:
(1) settle it through negotiation;
(two) to apply for mediation to the medical commission;
(three) to bring a lawsuit to the people's court;
(four) other ways as prescribed by laws, regulations and rules.
Twenty-fifth medical disputes, medical institutions should take the following measures to deal with:
(a) listen to the opinions of patients, inform them of the ways, methods and procedures to deal with medical disputes, answer relevant consultations and questions, and guide them to solve disputes according to law;
(two) to inform the relevant provisions of the medical record copying and sealing;
(three) the patient died in a medical institution, inform the relevant provisions on the disposal of the body;
(four) organize expert consultation when necessary, and inform the patients and their close relatives of the expert consultation opinions;
(five) need to start the emergency plan, should take measures in accordance with the provisions of the plan, and timely report to the local health and family planning, public security and other departments, and inform the medical commission;
(six) with the health and family planning, public security and other departments and the medical commission to do a good job in investigation and evidence collection and dispute handling.
Twenty-sixth medical disputes need to seal the medical records, it should be in the presence of both doctors and patients, * * * to confirm the medical records, and sign the copies or originals of the medical records. A medical institution shall keep a copy (duplicate) or original of the sealed medical record.
If the medical record has not been filled in and needs to be sealed, you can seal up the copy of the filled medical record first (copy); After the medical records are completed according to the regulations, copies (duplicates) of some subsequent medical records will be sealed.
Medical institutions can unseal medical records that have been sealed for 2 years and the patients have not claimed the responsibility for medical damage.
Twenty-seventh suspected of infusion, blood transfusion, equipment and other adverse consequences, both parties should * * * seal or unseal the physical objects on the spot, and the sealed physical objects on the spot shall be kept by medical institutions; If inspection is required and qualified, it shall be conducted by both doctors and patients and designated inspection institutions with inspection qualifications according to law; When the two sides cannot agree, it shall be designated by the administrative department of health and family planning.
Twenty-eighth patients died, and both doctors and patients failed to determine the cause of death or have objections to the cause of death, an autopsy should be conducted within 48 hours after the death of the patient; If the remains are frozen, it can be extended to 7 days. Autopsy shall be agreed and signed by the close relatives of the deceased. If the close relatives of the deceased refuse to sign without justifiable reasons, it shall be deemed that they do not agree with the autopsy. Refuse or delay the autopsy for more than the specified time, which affects the determination of the cause of death, and the party who refuses or delays shall bear the responsibility.
Both doctors and patients can invite forensic pathologists to participate in the autopsy, or appoint representatives to observe the autopsy process.
Twenty-ninth patients died in medical institutions, the patient's family should immediately transfer the body to the morgue, the longest shall not exceed 2 hours; The time for the remains to be stored in the mortuary shall not exceed 48 hours. If the medical institution has no mortuary, it shall transfer the body to the funeral home within 2 hours.
In violation of the provisions of the preceding paragraph, the remains that have not been processed within the time limit shall be notified by the medical institution to the funeral parlour to receive the remains after being approved by the competent department of health and family planning of the medical institution.
After receiving the notice from the medical institution, the funeral parlour shall quickly arrange vehicles and personnel to arrive at the scene, handle the formalities of receiving the remains in accordance with the regulations, and transport the remains to the funeral parlour.
Thirtieth prohibit any unit or individual from carrying out the following acts:
(a) beating the medical staff of a medical institution or intentionally damaging the health of medical staff or intentionally damaging public or private property;
(2) setting up a mourning hall, placing wreaths, burning paper money, hanging banners, blocking the gate or disturbing the medical order in other ways in a medical institution;
(3) illegally parking the remains in wards, rescue rooms, intensive care units and other places of medical institutions and public open areas of medical institutions, which affects the medical order;
(4) Illegally restricting the personal freedom of medical personnel and preventing them from leaving the workplace;
(5) publicly insulting, abusing, slandering or intimidating medical personnel;
(six) illegally carrying guns, ammunition, control equipment or explosive, radioactive, toxic and corrosive dangerous goods into medical institutions;
(7) Deliberately expanding the situation, instructing others to commit illegal and criminal acts against medical institutions or medical personnel, or committing acts such as extortion and provocation in the name of being entrusted by others to handle medical disputes;
(eight) other acts that disrupt the normal order of medical institutions.
Article 31 In the event of an act listed in Article 30 of these Measures, or a major medical dispute resulting in the death of a patient, serious personal disability or personal injury of more than three people due to medical negligence, the health and family planning administrative department of the people's government at or above the county level shall, after receiving the report from the medical institution, handle it according to the following requirements:
(a) instruct medical institutions to take immediate measures to prevent the situation from expanding, and organize personnel to be present to cooperate with the public security organs to do a good job in on-site disposal;
(two) publicity and education policies and regulations, and guide both doctors and patients to choose appropriate ways to solve disputes;
(three) notify the patient's unit or township people's government (street offices) and village (neighborhood) committees to participate in the handling of medical disputes.
Thirty-second public security organs shall, after receiving the early warning of medical disputes, handle them in accordance with the following provisions:
(a) immediately organize the police to the scene;
(two) to carry out education and guidance, find out the identity of the troublemakers at the scene, stop the excessive behavior, and maintain the order at the scene;
(three) to investigate and deal with all kinds of illegal and criminal acts on the spot according to law;
(4) If the illegal mortuary of a medical institution disturbs the medical order and persuasion and warning are ineffective, compulsory measures shall be taken according to law to take the criminal suspect away from the scene for investigation and handling;
(5) Whoever injures medical personnel by violence or illegally restricts their personal freedom shall stop it in time and be punished for public security or investigated for criminal responsibility according to law.
Section 2 Consultation and Mediation
Article 33 After a medical dispute occurs, if the amount claimed by both doctors and patients does not exceed 20,000 yuan, it can be settled through consultation. Doctor-patient consultation shall be conducted in accordance with the following provisions:
(1) The number of doctors and patients participating in the consultation shall not exceed 5, and valid identity documents shall be produced. More than 5 people, should be elected representatives to negotiate;
(two) to express opinions and demands in a civilized manner according to law, and not to be aggressive or illegal, and not to disturb the normal medical order;
(3) If consensus is reached through consultation, a written settlement agreement shall be made and signed.
Article 34 After a medical dispute occurs, both doctors and patients may apply to the medical mediation committee in the place where the medical dispute occurs for mediation. Those who choose to mediate by the Medical Commission shall abide by the relevant provisions of the People's Mediation Law.
Both parties may apply for mediation in writing or orally; If an oral application for mediation is made, the people's mediator shall record the basic information of the applicant, the disputed matters and the reasons for applying for mediation on the spot, and the applicant shall sign it for confirmation.
Knowing that a major medical dispute is occurring in a medical institution, the Medical Commission may appoint a people's mediator to rush to the medical institution to carry out on-site counseling and accept mediation applications.
Article 35 The Medical Commission shall perform the following duties:
(1) Accepting applications for mediation of medical disputes;
(two) to accept the consultation of all parties and guide both doctors and patients to solve medical disputes according to the principle of legality and voluntariness;
(3) Mediation of medical disputes;
(4) Other duties as prescribed by laws and regulations.
Article 36 The people's mediators of the Medical Commission shall be fair and upright, have good conduct, have medical and legal professional knowledge and mediation experience, and be enthusiastic about people's mediation work. City, county (District) Medical Commission should adhere to the combination of full-time and part-time, select people's mediators from medical, legal, psychological and other professionals, and establish a library of people's mediators in medical disputes.
The people's mediators of the Medical Commission have the obligation to keep confidential the privacy of patients and medical personnel or the business secrets of medical institutions that are known during the mediation process.
The judicial administrative department of the people's government at or above the county level shall regularly conduct professional training for the people's mediators of the Medical Commission. Training shall not charge any fees.
Article 37 The Medical Commission shall establish an expert database composed of relevant medical, pharmaceutical, psychological, insurance and legal experts to provide technical advice for the investigation, evaluation and mediation of medical disputes. The health and family planning and judicial administrative departments of the people's governments at or above the county level shall support and guide the establishment of the expert database.
Encourage the integration of regional medical dispute mediation expert resources in this province, and advocate the conditional medical adjustment Committee to promote the use of remote video consultation experts and participate in medical dispute mediation.
Article 38 After receiving the application for mediation of medical disputes, the Medical Commission shall conduct a review within 3 working days. Decided to accept, timely reply to the parties; If it is not accepted, it shall notify the parties in writing and explain the reasons.
After accepting the application for mediation, the Medical Commission shall inform both doctors and patients of their rights and obligations in the process of mediation.
Article 39 A medical mediation committee shall meet the following requirements when mediating medical disputes:
(a) determine 1 to 3 people's mediators as mediators. If there are more than 1 mediators, 1 mediators should be determined. If both doctors and patients have sufficient reasons to ask the mediator to withdraw, the mediator should withdraw;
(two) the parties may hire lawyers, entrusted agents and elected representatives to participate in mediation, and the number of unilateral representatives shall not exceed 5, and the entrusted party shall submit a power of attorney to the Medical Commission;
(3) Mediation shall be conducted in a specially set mediation place;
(four) when the people's mediators mediate, they should make mediation records.
Fortieth people's mediators should know the relevant facts and circumstances from both doctors and patients; Need to consult medical records or consult relevant experts and personnel, the relevant units and personnel shall cooperate.
Through persuasion and persuasion, people's mediators urge doctors and patients to reach a mediation agreement on the basis of equal consultation.
Article 41 For medical disputes with a claim amount of more than 20,000 yuan and less than 654.38+10,000 yuan, the Medical Commission shall consult relevant experts in its expert database to obtain expert opinions and mediation suggestions. For medical disputes with a claim amount exceeding 654.38+10,000 yuan, medical damage appraisal or medical accident technical appraisal should be conducted first to clarify the responsibilities.
Medical damage appraisal or medical accident technical appraisal shall be carried out in accordance with national laws and regulations.
Article 42 If the parties reach a mediation agreement, they shall make and sign a written mediation agreement.
After reaching a mediation agreement through mediation by the Medical Commission, both parties may, if necessary, apply to the people's court for judicial confirmation within 30 days from the date when the mediation agreement takes effect.
Forty-third medical commission shall complete mediation within 30 working days from the date of accepting the application for mediation, and the mediation period does not include the appraisal time. If it is necessary to extend the mediation period due to special circumstances, both parties may extend it through consultation; If no mediation agreement is reached within the agreed time limit, it shall be regarded as a failure of mediation.
Forty-fourth in any of the following circumstances, the medical commission will not accept it; If it has been accepted, the mediation shall be terminated:
(a) one party refuses to mediate or mediation fails;
(two) the parties to the people's court, the people's court has accepted or made a judgment;
(3) Disputes unrelated to medical institutions' diagnosis and treatment activities;
(4) Other circumstances stipulated by laws and regulations.
If the mediation is terminated, both parties shall be informed in writing and the reasons shall be explained.
Chapter IV Medical Liability Insurance
Article 45 The health and family planning administrative department of the people's government at or above the county level shall actively promote public medical institutions to participate in medical liability insurance according to regulations, and encourage non-public medical institutions to participate in medical liability insurance, medical personnel to participate in occupational liability insurance, and patients to participate in medical accident insurance.
Article 46 The underwriting institution of medical liability insurance shall, in accordance with the relevant provisions of the state, follow the principle of guaranteed capital and meager profit, scientifically determine the insurance premium rate, and negotiate with the medical institution to adjust the insurance premium rate according to the size of the medical institution, the risks of different clinical specialties and the compensation of medical disputes in previous years.
Encourage medical liability insurance underwriting institutions to develop diversified medical liability insurance products.
Forty-seventh medical institutions to participate in medical liability insurance, medical liability insurance fees charged in the medical expenses.
Article 48 After a medical dispute occurs, a medical institution shall, in accordance with the relevant provisions of the Insurance Law of People's Republic of China (PRC) and the provisions of the insurance contract, report the case to the medical liability insurance underwriting institution in a timely manner, and truthfully provide the underwriting institution with relevant information about the medical dispute.
Article 49 The underwriting institution of medical liability insurance shall, according to the insurance contract, take the effective conciliation statement or award made by the people's court, the conciliation agreement made by the medical adjustment committee and the settlement agreement reached by the medical insurance institution as the basis for medical liability insurance claims, pay in time and provide relevant insurance services.
Chapter V Legal Liability
Fiftieth acts in violation of the provisions of these measures, laws, regulations and rules have been punished, from its provisions.
Article 51 Where the health and family planning, judicial administration, public security, civil affairs and other departments of the people's government at or above the county level and their staff fail to perform their duties in accordance with the provisions of these Measures in the prevention and disposal of medical disputes, resulting in intensified medical disputes, major cases or other serious consequences, or illegally interfering in consultation and mediation, the competent department or supervisory organ shall give sanctions to the directly responsible person in charge and other directly responsible personnel according to law; If a crime is constituted, criminal responsibility shall be investigated according to law.
Fifty-second in violation of the provisions of these measures, medical institutions in any of the following circumstances, given a warning by the health and family planning administrative department of the people's government at or above the county level, shall be ordered to make corrections; Refuses to correct or cause serious consequences, the directly responsible person in charge and other directly responsible personnel shall be punished according to law:
(1) Failing to carry out professional ethics education and business training, or failing to establish a medical quality monitoring and evaluation system, a medical safety responsibility system and a fault accountability system;
(2) Failing to formulate a plan for handling medical disputes;
(3) Failing to set up a reception place, or not equipped with full-time (part-time) staff, and failing to announce the methods and procedures for resolving medical disputes and the responsibilities, addresses and contact information of relevant institutions such as the Medical Commission in a prominent position in medical institutions;
(four) failing to provide medical records copying or copying services as required.
Article 53 Medical personnel who violate the provisions of these measures under any of the following circumstances shall be punished by the health and family planning administrative department of the people's government at or above the county level according to the Law of People's Republic of China (PRC) on Medical Practitioners, the Drug Administration Law of People's Republic of China (PRC), the Nurses Regulations and other relevant laws and regulations; If the case constitutes a crime, criminal responsibility shall be investigated according to law:
(a) in violation of the norms and routine of diagnosis and treatment, the implementation of unnecessary inspection;
(two) the use of diagnosis and treatment techniques, drugs and medical devices that are not suitable for the condition;
(3) Concealing, tampering, forging, destroying or discarding medical records;
(4) accepting property from patients and their close relatives or seeking other illegitimate interests.
Fifty-fourth in violation of the provisions of these measures, the people's mediators of medical disputes have one of the following circumstances, and the people's mediation committee of medical disputes shall give criticism and education and order them to make corrections. If the circumstances are serious, they shall be dismissed according to law; If the case constitutes a crime, criminal responsibility shall be investigated according to law:
Take sides with one side;
(2) Insulting the parties concerned;
(3) Asking for or accepting property or seeking other illegitimate interests;
(4) disclosing the personal privacy of both doctors and patients.
Fifty-fifth in violation of the provisions of article thirtieth of these measures, disrupting the normal medical order of medical institutions, damaging public and private property, and infringing upon the legitimate rights and interests of others, the public security organs shall give administrative penalties for public security according to law; If a crime is constituted, criminal responsibility shall be investigated according to law.
Article 56 If news media or journalists make false reports on doctor-patient disputes with unknown truth and unpublished investigation results, or incite opposing emotions in their reports, resulting in serious social adverse effects and consequences, they shall be investigated for responsibility in accordance with relevant state regulations.
Article 57 The insurance supervision and administration institution shall deal with the insurance institutions and their responsible persons who refuse to perform the insurance benefits compensation obligations stipulated in the insurance contract according to law.
Chapter VI Supplementary Provisions
Article 58 The term "medical institutions" as mentioned in these Measures refers to institutions that have obtained the Practice License of Medical Institutions in accordance with the Regulations on the Administration of Medical Institutions.
The term "patients" as mentioned in these Measures includes patients, close relatives of patients and patients' agents.
Fifty-ninth medical disputes caused by illegal medical practice do not belong to the medical disputes mentioned in these measures, and shall be handled in accordance with relevant laws and regulations.
Article 60 These Measures shall come into force as of July 0+65438 1 day.