医生称工伤“48小时之限”不符合医理

Doctors say inductrial injury"48 hours limit"Do not conform to the principles of medical science

　　上班期间发病能否认定为工伤，历来争议颇多。立法又是一个博弈的过程，当初作出这样的规定，也是平衡各方利益的结果。但是回归到工伤保险的设计初衷，保障因工作遭受伤害的职工获得医疗救治和经济补偿，合理分担处在弱势地位的劳动者权益风险，这应当是首要目的。

During the work the can maintain for inductrial injury,Always dispute quite a lot.Legislation is a process of game,At the beginning to make such provisions,Is also the result of balancing the interests of both sides.But to return to the original design of inductrial injury insurance,Security because of working suffer harm worker get medical treatment and economic compensation,Reasonable sharing in the weak position of the rights and interests of every worker risk,It should be the primary purpose.

工伤之殇：48小时之外谁买单 Wounds of inductrial injury:48 hours outside who the check

　　10月27日，是51岁建筑工人尹广安的下葬之日。他在工作期间突发脑溢血被送往医院抢救。尹广安所在劳务公司的人极力让医生用呼吸机维持他的生命，至少维持48小时；而尹广安的儿子则为了使父亲被认定为工伤，决定撤下呼吸机，让父亲“自然”死亡。

On October 27,,Is 51 construction workers YinGuangAn buried of the day.He in the course of work he suffered a brain hemorrhage was taken to the hospital.In YinGuangAn labor services company's people were trying to let the doctor with breathing machine maintain his life,At least 48 hours to maintain;And the sons of YinGuangAn is in order to make the father was maintain for inductrial injury,Decided to remove breathing machine,Let our fathers"natural"death.

　　之所以纠结于“48小时”这个节点，是因为依据现行《工伤保险条例》，抢救超过48小时，死者将无法被认定为工伤，拿不到工伤赔偿。这种让因工而伤者家属面临“艰难抉择”的规定，初衷是什么？工伤认定能否有更人性化的操作方式？这条规定，应否适时进行修改？本报记者采访了有关专家。

Are entanglements in"48 hours"The node,Because according to current[Byelaw of inductrial injury insurance],Save more than 48 hours,The dead will not be maintain for inductrial injury,Can't get inductrial injury compensation.This let because Labour and the family face"Tough choices"regulations,Original intention is what?Whether the ascertainment of a work-related injury more humanized mode of operation?This rule,Should timely change?Our reporter interviewed experts.

视同工伤：初衷为保护，缘何引发新的不公 Inspect with inductrial injury:Original intention for the protection of,What sparked new injustice

　　“48小时之限”依据的是现行《工伤保险条例》的第15条规定：职工“在工作时间和工作岗位，突发疾病死亡或者在48小时之内经抢救无效死亡的”，“视同工伤”，“享受工伤保险待遇”。

"48 hours limit"Based on the current[Byelaw of inductrial injury insurance]The provisions of article 15:worker"In work time and work,Sudden illness or death within 48 hours after the rescue invalid death","Inspect with inductrial injury","Enjoy treatment of inductrial injury insurance".

　　山东省农民工维权站执行主任李强在接受本报记者采访时说，视同工伤，指的是并非认定为工伤，但为了扩大工伤补偿待遇的惠及人群，而将两者赔偿方式对等，实际上扩大了工伤认定的范围。按理说，这条法规的初衷既是为了保护更多的劳动者，也防止突发疾病无限制地纳入工伤保险的范围。但实践中，“48小时之限”却备受诟病。

Shandong peasant worker standing executive director li qiang in accepting our newspaper reporter to interview,Inspect with inductrial injury,Refers to is not maintain for inductrial injury,But in order to expand inductrial injury compensation treatment benefit people,And the way to indemnify equivalence,In fact expanded the scope of inductrial injury is maintained.By rights,The law of the original intention is to protect more workers,Also prevent sudden disease unrestrainedly included in the scope of inductrial injury insurance.But in practice,"48 hours limit"But for the.

　　李强认为，突发疾病的起因非常复杂，在实际生活中难以界定得泾渭分明。有些突发疾病跟工作时间、工作强度、工作性质有很大关系，这样即使抢救超过48小时不被视同工伤，也改变不了“因工而伤”的本质。

Li qiang think,The cause of a disease is very complex,In real life is difficult to define have to be quite distinct from each other.Some unexpected disease with working time/Working strength/There is a great relationship between the nature of the work,So even if rescue more than 48 hours will not be regarded as inductrial injury,Will change"Because Labour and injury"The essence of.

　　同时，随着医学的发展，病人的心跳、呼吸、血压等体征都可通过药物和先进设备加以干预或维持。条例认定死亡的标志是“呼吸停止”，所以以呼吸机和药物维持的生命时间也被算在抢救时间内，令更多被极力抢救的劳动者失去了认定为工伤的机会。很多突发疾病者的亲属不得不在“保命”还是“保工伤”之间抉择。

At the same time,With the development of medical science,The patient's heart/breathing/Blood pressure signs can be through the drugs and advanced equipment to intervention or maintain.That regulation is the sign of the death"Respiratory arrest",So to breathing machine and drug maintain life time are included in the rescue time,Make more is trying to rescue workers lost the chance to maintain for inductrial injury.A lot of unexpected ill relatives had to"life"or"Insurance inductrial injury"Choice between.

　　李强指出，条例如此规定或许也是经过调查论证，确定的一个相对科学的时间节点。但这种一刀切的方式，只以时间来作为认定标准，难免带来新的不公平，造成“没死不算工伤”和“抢救超过48小时不算工伤”两种情形索赔无望的现象，更有一些无良企业为躲过工伤赔偿，恶意拖延治疗时间。

Li qiang pointed out that,The regulations are so regulation may also be demonstrated through investigation,Established a relatively scientific time node.But this one size fits all way,Only in time to as determination standards,Unavoidably bring new unfair,cause"Don't refuse to calculate inductrial injury"and"Save more than 48 hours not inductrial injury"Two kinds of situations claim hopeless phenomenon,No more have some good enterprise to avoid inductrial injury compensation,Malicious delay treatment time.

　　西安政治学院法学副教授傅达林在接受记者采访时说，尹广安的悲剧，其原因与制度的设计有关。“如果一项规定在实践中迫使一个人陷入早点死、看时间死的境地，那么立法的科学性与正当性则需要检讨。由于我国没有脑死亡的具体标准，用人单位完全可以凭先进的医疗技术将病人的死亡时间拖至48小时以后，所以这种漏洞需要弥补。”

Xian political college, an associate professor of law FuDaLin when accepting a reporter to interview,YinGuangAn tragedy,Its reason and system design relevant."If a paragraph in practice force a man falls into early death/Look at time of death situation,So legislation more scientific and reasonable is need to review.Because our country without the specific standard of brain death,Unit of choose and employ persons can completely by advanced medical technology will the patient's death time tow to 48 hours later,So the loophole need to make up for."

工伤认定，应多些人性化操作 Inductrial injury to maintain,Should be more human operation

　　之所以强调认定工伤与非工伤，最重要的原因莫过于赔偿额的差异。李强给记者讲了另一起案例：山东济宁建筑工人杨亮在加班时突发脑溢血，抢救4天后死亡。杨亮家属委托李强代为申请工伤认定被驳回，原因也是“死亡超时”。以杨亮为例，若被认定为工伤，杨亮家属将获得工伤赔偿约40万元到50万元左右；而认定为非工伤，家属则只能拿到两三万元的殡葬费补偿。赔偿额少了几十万元，皆因他家人倾力抢救、让他“多活”的那些日子。

The reason that emphasize inductrial injury and the inductrial injury,The most important reason is the difference of compensation.Li qiang speak to reporters another case:Shandong jining construction workers in overtime YangLiang when he suffered a brain hemorrhage,Rescue death four days later.YangLiang family entrust li qiang to apply for ascertainment of a work-related injury was dismissed,Reason is also"Death overtime".To YangLiang as an example,If be maintain for inductrial injury,YangLiang families will get inductrial injury compensation of about 400000 yuan to 500000 yuan;And that is a inductrial injury,Families can only get a couple of ten thousand yuan of funeral and interment cost compensation.Compensation less hundreds of thousands of yuan,All because of his family tilting force rescue/Let him"live"Of those days.

　　“从立法上讲，规定越细致，当然越具有可操作性。”傅达林说，由于工伤造成人的伤亡具体情况十分复杂，如果时间过长，也可能难以区分死亡是否为工伤导致的结果，所以立法确定48小时内，增强了执法的可操作性。“但是可操作性只是立法的一个技术性问题，它不能损害到立法的正当性和价值取向。48小时的规定，有了法律上的可操作性，但被指不人道。实际上，人性化操作也未必不可。”

"From the legislation on,Careful regulation,Of course the more operable."FuDaLin said,Because of inductrial injury caused casualties specific situation is very complicated,If time is too long,May also be difficult to distinguish whether the death as the result of inductrial injury,So legislation sure within 48 hours,To enhance the law enforcement maneuverability."But the operability is legislation a technical problem,It cannot hurt its justice and value orientation.The provisions of the 48 hours,A legal operability,But be refers to the inhuman.In fact,Humanized operate also may not do not."

　　早在1991年，山西工人郭云梅经常加班加点工作，在车间上班时发生高血压脑出血，经抢救治疗后瘫痪。但工厂不同意报工伤。双方僵持未果。1994年山西省劳动厅针对这种情况请示劳动部，1996年7月，劳动部办公厅发回《关于在工作时间发病是否可比照工伤处理的复函》，指出：“对于个别特殊情况，例如由于加班加点突击任务而突然发生急病，可以当做个别特殊问题，予以照顾，比照因工死亡待遇处理。”

As early as in 1991,Shanxi workers GuoYunMei often overtime work,Go to work in the workshop occurs when hypertension cerebral hemorrhage,After the rescue paralysis after treatment.But the factory does not agree to quote inductrial injury.Both sides stalemate not if really.In 1994, shanxi provincial Labour department, in this kind of situation ask for instructions department of labor,In July 1996,Labor department general office back[About the time whether can the work in the reply of inductrial injury treatment],Pointed out that:"For individual special circumstances,For example due to work overtime assault task and sudden acute disease,Can treat as individual special problems,To take care of,Because be versed in dead pay in processing."

　　厦门也曾有过实践。2008年，工程师肖文旭于在开会发言时突发脑溢血，抢救3天后死亡。厦门市劳动和社会保障局认为利用呼吸机延续病人生命超过48小时后死亡的，理应视同工伤，也给予办理了工伤手续。

Xiamen also had practice.In 2008,,The engineer in the meeting XiaoWenXu speak he suffered a brain hemorrhage,Rescue died three days later.Xiamen city labor and social security bureau think use of breathing machine continue patient life more than 48 hours after the death,Should inspect with inductrial injury,Also gives to deal with the formalities of inductrial injury.

　　傅达林认为，这种关于工伤认定的“例外规定”和人性化操作，既符合劳动部的文件精神，也并不违背《工伤保险条例》的立法初衷，是应当被提倡的。

FuDaLin think,This about the ascertainment of a work-related injury"Exceptions to this rule"And humanized operation,Not only conforms to the department of labor of the spirit of the documents,Also is not against[Byelaw of inductrial injury insurance]Intention of lawmaking,Is the should be advocated.

回归立法初衷：合理分担劳动者权益风险 Regression legislation purpose:Reasonable sharing the rights and interests of every worker risk

　　郭云梅事件后，1996年7月，劳动部发布《企业职工工伤保险试行办法》，规定：“在生产工作的时间和区域内……由于工作紧张突发疾病造成死亡或经第一次抢救治疗后全部丧失劳动能力的”，应当认定为工伤。按照这条规定，很多在岗位上突发疾病死亡的职工，不论抢救时间长短，均可被认定为工伤。

GuoYunMei incident,In July 1996,The labor department issued[Company worker inductrial injury insurance for trial implementation measures],provisions:"In the time that produces the job and area...Because working strain breaks out of the disease causes death or the first rescue after treatment all lose labor ability",Should maintain for inductrial injury.According to this rule,Many in the post a disease to die worker,No matter the rescue time length,All can be maintain for inductrial injury.

　　但2004年，脱胎于《企业职工工伤保险试行办法》的《工伤保险条例》施行后，虽然增加了视同工伤的情形，却生硬地将抢救时间卡在48小时。因加班加点突发疾病而在抢救48小时后死亡的职工，赔偿待遇一下倒退到1996年7月前。“劳动部1996年对山西省劳动厅复函体现出的以人为本、保护劳动者的宗旨，应当在条例中有所体现。”李强说。

But in 2004,Emerged from[Company worker inductrial injury insurance for trial implementation measures]of[Byelaw of inductrial injury insurance]After the enforcement of,Although increased inspect with inductrial injury situation,But stiffly will save time card in 48 hours.For overtime sudden disease and in rescue 48 hours after the death of the worker,Compensation for the treatment of back to 1996 years before July."The labor department in 1996 in shanxi provincial Labour department reply reflects the people-oriented/The purpose of protection of laborer,Ought to be in regulations reflected somewhat in."Li qiang said.

　　事实上，《工伤保险条例》曾于2010年修改，于2011年实施。但新条例并未对“48小时之限”这一争议性问题进行修改。有人提出对策，要么取消48小时的限制性规定，直接规定经抢救无效死亡的视同工伤；要么作出例外规定，比如经抢救后依赖呼吸机等辅助设备维持生命的，不受48小时的限制。

In fact,[Byelaw of inductrial injury insurance]Change in 2010,In 2011 implementation.But the new regulations to did not"48 hours limit"The controversial problems modified.Someone put forward countermeasures,Or cancel 48 hours of restrictive provisions,The direct provision after the rescue invalid death shall be regarded as inductrial injury;Either make exceptions to this rule,Such as the rescue rely on breathing machine and so on after auxiliary equipment support life,From the limitation of the 48 hours.

　　傅达林认为，我国立法的精神是，工伤的认定更强调当事人遭遇的事故、意外伤害或职业病，而对一般岗位突发疾病则以死亡作为工伤条件。第一种方式有矫枉过正之嫌，走向另一种一刀切的极端；而例外规定依然无法穷尽所有。

FuDaLin think,Our country legislation spirit is,The inductrial injury that more emphasis on the parties had the accident/Accidental injury or occupational disease,For general post is a disease with death as inductrial injury condition.The first kind of way have hypercorrection too,Go to the other extreme of a one size fits all;And the exception provision is still unable to end all.

　　傅达林指出，上班期间发病能否认定为工伤，历来争议颇多。立法又是一个博弈的过程，当初作出这样的规定，也是平衡各方利益的结果。但是回归到工伤保险的设计初衷，保障因工作遭受伤害的职工获得医疗救治和经济补偿，合理分担处在弱势地位的劳动者权益风险，这应当是首要目的。

FuDaLin pointed out that,During the work the can maintain for inductrial injury,Always dispute quite a lot.Legislation is a process of game,At the beginning to make such provisions,Is also the result of balancing the interests of both sides.But to return to the original design of inductrial injury insurance,Security because of working suffer harm worker get medical treatment and economic compensation,Reasonable sharing in the weak position of the rights and interests of every worker risk,It should be the primary purpose.

　　“一部高质量的工伤保险立法不是竭尽全力防范极个别人钻空子，而是应从更普遍的意义上确立起保护劳动者权利的价值准则。具体的完善方式，关键是要在死亡结果与死亡原因之间确立工伤的联结，更多的时候需要正确的执法解释。”傅达林说。 (记者 张灿灿程振楠)

"A high quality inductrial injury insurance legislation is not try our best to prevent pole individuals exploit an advantage,But more common sense should be established to protect workers' rights value criterion.The improvement of the specific way,The key is to death in the cause of death and to establish the connection between inductrial injury,Most of the time it is necessary to correctly law enforcement to explain."FuDaLin said. (Reporter ZhangCanCan ChengZhenNan)