信賴原則在醫療分工之適用－以護士麻醉致死案為例

Division of Medical Treatment Work and Principle of Reliance-A Case Analysis

張麗卿(Li-Ching Chang)

《東海大學法學研究》 33期 (2010/12) Pp. 45-77

https://doi.org/10.29722/TULR.201012.0002

摘要

沒有醫療分工的醫療在現代醫學已經無法想像，故醫療分工是當前社會所必須容許的風險。在容許風險的概念下，自然就有信賴原則的適用。信賴原則，指在具有危險的社會活動中，若行為人本身未違反規範，且可信賴他人的行為是遵守規範而沒有製造任何危險時，縱產生結果，亦不被歸責。醫療分工行為，以是否有受到指示上的拘束為標準，分為垂直分工與水平分工。本文認為，信賴原則無論垂直分工或水平分工皆有適用可能，關鍵在於醫療參與者有無遵守注意義務，因為每位醫護人員都是專門職業技術人員，對於本身工作領域的專業知識及工作態度，應可被合理期待符合一定水準和小心謹慎。本文所舉的不幸案例，乃醫療輔助人員工作態度輕率的問題，這個範圍不應是醫師監督責任的領域，否則護理人員的每個工作細節，若都要經過醫師的核對確認，則護理人員之於醫師，不是「助力」而是「負擔」。

關鍵字

信賴原則 ； 醫療分工 ； 業務過失 ； 預見可能 ； 麻醉

並列摘要

As we can't imagine modern medical science without division of medical treatment work, division of medical treatment work is therefore counted as a permitted risk in present society. Under the concept of permitted risk, the principle of reliance should be applied in medical treatment work. Principle of reliance is defined as supposing a person, under the expectation of trusting others also acting rightfully, acting rightfully and creating no risk in dangerous social activities; even though his certain behavior does result in any offenses, still he should not be condemned.Division of medical treatment work can be classified as horizontal division of work and vertical division of work according to whether the restriction of superior order is receiving or not. In this we will introduce the concept that as long as the medical personnel, whether they are participants in the horizontal division of work or vertical division of work, are abiding by the foresight obligation in the division of medical treatment, they should not be condemned for any offenses under the usage of the principle of reliance. Since the medical personnel are all expertise, they are expected, in common sense, to possess high standard of professional knowledge and alertness in their professional field and working attitude.Cases in this article pointed out that attitude of medical assistants caused negligence to medical team. Within the scope, negligence is not responsible for doctors. If every single detail must be supervised by doctor, nursing conducts to doctor are burdens but not supportive.

並列關鍵字

Principle of Reliance ； Division of medical treatment work ； Professional Negligence ； Foresight possibility ； Anesthesia

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