在病人安全运动的推动下,从上世纪80年代开始美国各州陆续制定了道歉法案,并逐渐确立了排除医师道歉自认效力的制度。该制度实施以来,理论界一直争议不断。各州的医师道歉制度在内容、形式、时间、对象及是否仅适用于诉讼程序方面不尽相同,也导致实务中医师因担心法律风险而拒绝道歉,以及法院挑选等问题。不过,理论和实证研究数据均表明,该制度的确能够减少医疗诉讼数量、降低医疗损害索赔数额,从而缓和医患关系。为了使其更好的发挥作用,学者们提出了对联邦证据法的修订建议。在构建和谐医患关系的目标下,该制度及其对证据法的影响,值得我国加以学习和借鉴。 Driven by the patient safety movement, the U.S. states have successively formulated the apology act since the 1980s and have gradually established a system that excludes physicians from apologizing for their own validity. Since the system was implemented, theorists have been constantly controversial. The physicians’ apology system in different states varies in content, form, time, object and whether they apply only to the litigation procedure. It also causes the practicing physicians to refuse to apologize for fear of legal risks and the selection of the court. However, both the theoretical and empirical data show that the system can indeed reduce the number of medical claims and reduce the amount of claims for medical damages, thus alleviating the doctor-patient relationship. In order to make it play a better role, scholars proposed amendments to the federal evidence law. Under the goal of building a harmonious relationship between doctors and patients, the system and its impact on evidence law deserve our country’s study and reference.