實證醫學在醫療過失審判實務上的意義－從胃腺癌存活率談起

The Meaning of Evidenced-based Medicine to Negligence Suit-The observation on Survival Rate of Gastric Carcinoma

張麗卿(Li-Ching Chang)

《東吳法律學報》 21卷2期 (2009/10) Pp. 1-30

https://doi.org/10.6416/SLR.200910.0001

摘要

醫療糾紛是現代社會最常見的訴訟來源之一，因此為保障人民的權利以及因醫療糾紛所產生的事實能夠獲得雙方的共識，在法庭上必須呈現醫療糾紛的相關證據，但是因為醫療具有高度專業性，所以必須仰賴具有醫學專業能力者進行鑑定。
近年來隨著實證醫學的發展，傳統的經驗醫學有逐漸被取代之勢。在我國醫界也興起一股新的浪潮，同時反映於我國司法實務在處理醫療糾紛時的態度。其中反應在司法程序上，就是實證醫學於醫療糾紛的運用上愈形重要，甚至扮演關鍵角色。
本文以醫師在認定是否有切片檢查必要的主張，透過實證醫學作為其醫療行為之準則，經由實證醫學的運作，得知在文獻記載下的胃腺癌存活率的高低，可使法官在判斷醫療疏失以及因果關係時，得到更為明確的證據認定，進而使雙方當事人獲得公平而有可信度的判決，故相關的實證醫學（醫學文獻資料）為基礎，探討法官為民事訴訟勝敗判決，以及刑事判決是否有罪的關鍵。

關鍵字

過失 ； 重大過失 ； 實證醫學 ； 醫療糾紛 ； 告知義務

並列摘要

Medical malpractice lawsuits occur often in modern society. In order to protect the right of patient and make the facts of causing medical malpractice can reach consensus for both parties; court must handle related evidences of medical malpractice. However, medical service is highly professional that must conducted by professional experts to do examination for lawsuits.
As time goes by, traditional experience medicine seems to be replaced by the development of Evidence-Based Medicine gradually. Evidence-Based Medicine played an important role exercised by Medical Malpractice lawsuits which turned out to be a new wave in medical community of Taiwan. Simultaneously, Evidence-Based Medicine became a key factor influencing the attitude of court toward Medical Malpractice in legal procedure.
This article assessed that doctor whether a delay or failure in diagnosis makes biopsy. Evidence-Based Medicine is an important assessment of what a standard physician exercise. By literature review for mortality and survival analysis, the mortality rates of gastric adenocarcinoma would assist the judge successfully handling medical malpractice cases. Evidence-Based Medicine also can assist judge to figure out the evidence of establishing negligence and relationships between cause and factor. Both parties can benefit from a just and reliable trial. Meanwhile, Evidence-Based Medicine research materials would provide the reference for judge making judgment for civil case and criminal case.

並列關鍵字

Evidence-Based Medicine ； Medical Malpractice ； Informed Consent ； Negligence ； Gross Negligence

參考文獻

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