刑事醫療判決關於告知義務變遷之研究

The Change of Inform Obligation in Criminal Judgments

張麗卿(Li-Ching Chang)

《東海大學法學研究》 39期 (2013/04) Pp. 99-179

摘要

告知義務是指，醫師在進行醫療行為前，有義務對病人說明病情、可能診斷方式的選擇及其風險等事項，賦予病人充分自主空間，讓病人得以接受、選擇或拒絕醫療方案的義務。近年來，隨著醫療普及與國民權利意識抬頭，醫師疏於告知義務的履行，時常是引發醫療糾紛的主要原因。值得觀察的是，刑事醫療訴訟中，告知義務是否如同醫師應盡的注意義務，醫師一旦疏於告知義務的履行，是否就會導引出刑事過失的歸責效果，都涉及到實務判決對告知義務本身的看法與態度。本文以司法實務開始關注有關告知義務的刑事判決為主，將告知義務分為三個遞嬗的時期，包括：早期於2001年至2004年間，尚未著重醫師告知義務履行的「萌芽期」；從2005年最高法院作成94年度台上字第2676號判決後，邁入重視實質告知義務與強調結合過失責任的「發展期」；以及近年來，更進一步深化告知義務內涵，並且反思告知義務與刑事過失責任之間效果關聯的「修正期」，希冀藉由實務判決意見的轉變，勾勒出台灣近年來告知義務的脈絡與軌跡，並澄清告知義務違反與刑事責任成立的關連性。

關鍵字

告知義務 ； 注意義務 ； 病人自主決定權 ； 醫療過失

並列摘要

”Inform obligation” is a physicians' obligation to the patient. It requires physicians to inform patients the description of the disease, the choice of diagnostic methods, the risk issues. Furthermore, ”Inform obligation” is to give patients more space and ability to decide how to accept, select or reject the physicians' medical program. Recently, with the rise of medical disputes and popularity of the medical awareness, Physicians' neglect to inform obligation is often the main cause to medical disputes. It should be observed if the inform obligation is the physicians' additional medical care? If the physicians do not perform this kind of ”inform obligation”, is it a criminal case of negligence? These problems are related between the judgments and inform obligation.This article is based on the judgments of different courts in Taiwan in the past ten years. In order to clarify the related concepts, this article is divided into three periods according to the criminal judgments. The early one is from 2001 to 2004, a time to germinate. The second one is from 2005 to 2008, a time to develop. The third one is from 2009 to now, a time to adjust.This article not only focuses on what the concept ”inform obligation” is, but also discusses its development in the Supreme Court in Taiwan.

並列關鍵字

Inform obligation ； Attention obligation ； Patients autonomy ； Medical negligence

參考文獻

王皇玉(2007)。論醫療行為與業務上之正當行為。臺大法學論叢。36(2)，41-91。

王皇玉(2006)。論醫師的說明義務與親自診察義務－評九十四年度台上字第二六七六號判決。月旦法學雜誌。137，265-280。

王皇玉()。

甘添貴(1992)。刑法總論講義。瑞興=Ruixing。

甘添貴(2004)。治療行為與傷害。月旦法學教室。15，18-19。