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目的为探索当前我国保外就医的特点,揭示保外就医中存在的问题,为制定有关政策法规提供参考依据,同时探讨保外就医的审查过程中法医学鉴定的必要性。方法两名研究人员从1992—1997年6年期间的司法鉴定资料中筛选出与保外就医有关的法医学鉴定案例,三名研究人员根据既定条件确定研究对象,并进行统计学分析。结果符合条件者共54例,主要年龄范围为20—50岁,罪名分类发现经济性犯罪明显多于非经济性犯罪,前者51例(94.4%),后者3例(5.55%)。提出保外就医申请的理由以单纯病名和主要症状者居多,少有提出辅助症状者,法医学鉴定表明检查结果与申请理由一致者为14例(25.92%),不一致者为40例(74.04%);进一步鉴定揭示患有疾病确需保外就医者仅为3例(5.55%),而无需保外就医者高达51例(94.4%),其中无病者32例(59.25%),夸大病情者19例(35.18%)。结论本研究提示当前保外就医中犯罪装病、夸大病情等现象明显严重,这与保外就医所经历的中间环节缺乏有效的监督体制有关。因此,单纯以医疗系统进行保外就医鉴定是难以保证法律的公正执行。
Objective To explore the current characteristics of overseas medical treatment in our country, to reveal the existing problems in medical insurance and to provide reference for the formulation of relevant policies and regulations, and to explore the necessity of forensic identification in the process of medical insurance review. Methods Two researchers screened forensic identification cases related to out-of-pocket medical care from the forensic data during the six-year period from 1992 to 1997. Three researchers determined the subjects according to established conditions and conducted statistical analysis. Results A total of 54 cases were eligible, the main age range of 20-50 years old, found that the category of crime was significantly more economic crimes than non-economic crimes, the former 51 cases (94.4%), the latter 3 cases (5.55% ). The reasons for applying for medical insurance for overseas doctors were mostly simple name and main symptom, and few were found to have auxiliary symptoms. Forensic medical examination showed that the examination results were consistent with the application reason in 14 cases (25.92%) and inhomogeneous cases were 40 cases (74.04 %). Only 3 patients (5.55%) did not need to be insured for further identification, and 51 patients (94.4%) were uninsured. Among them, 32 patients (59.25% 19 cases (35.18%) exaggerated the condition. Conclusions This study suggests that there is a clear and serious current situation of illegal drugs in hospitals and exaggerated cases, which is related to the absence of an effective supervisory system in the intermediate links experienced by medical parole. Therefore, it is difficult to guarantee the fair implementation of the law simply by using the medical system to carry out the medical assessment.