Abstract: At present, there is a phenomenon of “dualization” in medical damage appraisal. The main body of medical damage appraisal includes the medical associations and judicial appraisal institutions. In the practice of appraisal, the client often requires an appraisal body to quantify the consequences of personal injury to patients who are still alive.  The commonly used quantitative method in practice is disability rating. However, in the practice of medical damage appraisal, the applicable standards for disability rating are not uniform.The disability grades may be inconsistent, which is easy to cause confusion and disputes, and is not conducive to the proper handling of medical injury cases. This paper will start from the problems existing in the quantitative assessment of the damage consequences conducted by medical associations and judicial appraisal institutions in medical damage appraisal cases, discuss the subject of disability assessment of damage consequences and the application of standards, and hope to provide unified and standard reference opinions for solving the problem of medical damage compensation, promote the smooth progress of litigation, and help efficiently resolve disputes between doctors and patients.

Key words: medical damage, damage consequence, assessment of disability, dualization

摘要： 当前医疗损害鉴定存在“二元化”现象，主要体现为医疗损害鉴定的主体包括医学会和司法鉴定机构。在鉴定实践中，委托人常需要司法鉴定机构对存活患者的人身损害后果进行量化评价，实践中常用的量化方法是进行残疾等级评定。然而在医疗损害鉴定实务中残疾等级评定适用标准不统一，残疾等级可能不一致，容易引发不解和争议，不利于医疗损害案件的妥善处理。从医学会及司法鉴定机构在医疗损害鉴定案件中对损害后果定量评定存在的问题出发，就损害后果残疾评定主体及标准适用问题进行探讨，并期望为医疗损害赔偿提供统一标准的参考意见，促进诉讼活动的顺利进行，也有利于高效化解医患纠纷。

关键词: 医疗损害, 损害后果, 残疾评定, 二元化