【作者简介】张龙，南开大学周恩来政府管理学院社会学系。

【文章来源】《社会》2023年第5期。

【内容提要】对医疗损害赔偿的既有研究通常将重心放在赔偿制度或赔偿后果上，但是对确定赔偿金的微观社会过程，尤其是医疗损害纠纷中不同性质的损失和数量化的处理后果之间存在的张力，学界缺乏足够关注。基于笔者在中国北方某市三甲医院纠纷处理科室的田野调查，本文试图呈现不同渠道下医疗损害赔偿的完整“定价”过程。本文认为，医疗损害纠纷中的关键争议离不开通约，即将不同的属性转化为同一数量尺度的社会过程。研究发现，医疗损害纠纷中的通约实践通常在价值(价值的整合)、认知(信息的简化)和技术(测量的精准)三个维度展开，并且因不同渠道的制度化程度和不同属性的可通约程度而呈现不一样的展开形式。

【关 键 词】医疗纠纷；医疗损害赔偿；赔偿金；通约

【全文链接】https://www.society.shu.edu.cn/CN/Y2023/V43/I5/112

"Pricing" Injuries: Practice of Commensuration in Medical Injury Disputes

ZHANG Long

Abstract: Existing studies on medical injury compensation often focus on institutional arrangement or financial outcomes. They are lack of sufficient attention to the micro-social processes that determine compensations, especially the tension between the different kinds of losses and the quantitative outcomes of resolution. Based on the fieldwork in a dispute resolution department of a public city hospital in northern China, this study presents the comprehensive medical injury compensation "pricing" processes under different channels. The paper argues that the crucial parts in medical injury disputes inevitably involve commensuration, a social process by which different factors are being quantified onto the same scale. By introducing the concept of commensurative practice, this study depicts the formation of compensation amounts as an accumulative process of multiple micro-based commensurative practices. The study finds that the commensurative practices in medical injury disputes are usually unfolded in three dimensions: value (integration of values), cognitive (simplificationofinformation)andtechnical (accuracyofmeasurement). There are two factors affecting specific ways of commensuration that can cause dimensional shifts. On one hand, the less institutionalized the interaction context, the more prominent the value dimension in the commensurative practice, while the more institutionalized interaction context most likely results in more cognitive and technical commensuraition. On the other hand, the more directly commensurative practices target the "incommensurable" or "not easily commensurable" attributes, the more prominent the dimension of value commensuration, while the attributes of whatisconsidered"commensurable" or "easilycommensurable"aremoreoften accompanied by cognitive and technical commensuration. The main focus of this study is to present as well as compare commensurative practices of "incommensurables" under the channels of different institutionalisation.

Key words: medical injury dispute； medical injury； compensation； compensationcommensuration