Currently, forensic appraisal has been extensively involved in the responsibility identification of medical damages. Forensic doctors differ greatly from clinical doctors. Forensic doctors are not clinical medicine experts; they mainly deal with corpses and have a certain background in legal education, but they have deficiencies in evaluating clinical professional standards, and the self-construction level of judicial appraisal institutions is unbalanced. Most personnel who have experienced judicial appraisals, including handling judges and both parties in doctor-patient relationships, often say that this is amateurs appraising professionals, and there are various objections to the conclusions of judicial appraisals. Since most forensic doctors lack clinical experience and corresponding specialized medical knowledge, it leads to their inability to use uniform standards for appraisals, such as gynecological inflammations, which results in each person having their own standard, making it difficult to reflect fairness. Medicine is an extremely professional science. Based on its professionalism, complexity, and technicality, medical damage appraisals are not work that general forensic doctors can handle. Therefore, using only forensic opinions as the basis for identifying medical damage responsibilities has many problems.
In practice, judicial appraisal fees are high (a single judicial appraisal fee is much higher than the cost of two medical accident technical appraisals). If patients request a judicial appraisal, the appraisal fee is borne by the patient, leading to a phenomenon: if the judicial appraiser believes the hospital has no responsibility, the appraisal institution feels unable to explain to the patient, thus resulting in situations where the hospital actually has no responsibility, but the appraisal conclusion indicates otherwise.
From a legal perspective, currently, whether in the civil law system or the common law system worldwide, the principle of peer appraisal is adopted in the judgment of professional technology (which is also known as our country's medical accident technical appraisal). This should be the vitality of the evidence form of appraisal conclusions.
The current construction of the medical damage appraisal system should be vigilant against formalistic appraisal fairness leading to substantive appraisal injustice, and vigilant against legal protection of patients causing harm to patients through medical means. Ignoring the professionalism of appraisers will fail to ensure scientificity, and without scientific appraisal conclusions, what use is there in mere fairness? Fairness can be ensured through institutional design. Of course, the current medical association's medical accident technical appraisal should further improve related systems (such as renaming to medical damage technical appraisal, establishing expert appraiser signatures, appraiser courtroom appearances, regional exchanges of appraisal experts, participation of judicial appraisers, etc.), so as to fully demonstrate the scientificity and fairness of the appraisal, and will certainly help balance doctor-patient conflicts and contradictions, promoting harmonious development of doctor-patient relationships.
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