Abstract: Forensic appraisal of medical damage needs high quality standards to improve its scientific nature，consistency and reliability. The existing Guidelines for Forensic Appraisal of Medical Damage exhibit limited effectiveness in resolving the standardized practice conundrum of psychiatric medical damage forensic appraisal. They fail to genuinely address practical challenges such as the inconsistent professional background requirements for psychiatric medical damage appraisers，the unclear efficacy of statements from individuals assessed with mental disorders，the ambiguous boundary division of current professional classification standards for appraisal scope，and the absence of professional operational guidelines for psychiatric malpractice assessment. At present，the development of the Guidelines for Forensic Appraisal of Psychiatric Medical Damage represents a novel breakthrough for resolving these genuine difficulties. Analyzing the Guidelines for Forensic Appraisal of Medical Damage and appraisal practices，it is anticipated that new insights will emerge for the standardization of psychiatric medical damage forensic appraisal. The crux of overcoming genuine difficulties lies in formulating industry standards to regulate the appraisal process，encompassing explicit requirements for appraisers’ professional backgrounds，the establishment of a specialized hearing system involving the individual being assessed，precise delineation of the appraisal scope for psychiatric medical damage，and standardized classification of psychiatric malpractice types. These aspects should be integrated into the Guidelines for Forensic Appraisal of Psychiatric Medical Damage. Moving forward，the standardization governance of psychiatric medical damage appraisal should be initiated by this guideline and continually refined and amplified.

Key words: psychiatry, medical malpracitce, appraisal standard, standardization of forensic appraisal

摘要： 医疗损害司法鉴定需要高质量标准，以提高司法鉴定的科学性、一致性和可靠性。既有的《医疗损害司法鉴定指南》难以破解精神科医疗损害司法鉴定标准化实践困境，无法真正解决精神科医疗损害鉴定人专业背景要求不一、精神障碍被鉴定人陈述效力不清，以及现行执业分类规范对鉴定范围划分界限模糊、精神科医疗过错评价缺乏专业化操作细则等实践难题。在司法鉴定法治化的风口，通过制定《精神科医疗损害司法鉴定指南/指引》破解真难题已成为新的突破口。基于对《医疗损害司法鉴定指南》以及鉴定实践的分析，有望为探讨精神科医疗损害司法鉴定标准化问题提供新思路。破解真难题的核心是制定行业标准、规范鉴定，包括明确具备精神科培训经历为关键的鉴定人专业背景要求，被鉴定人参与的专业化听证制度，精神科医疗损害鉴定范围的准确划分以及精神科医疗过错类型的标准化划分。而上述内容均应囊括于《精神科医疗损害司法鉴定指南/指引》，未来精神科医疗损害司法鉴定标准化治理当以该指南为肇始，并不断深化完善。

关键词: 精神科, 医疗损害, 鉴定标准, 司法鉴定标准化