整合中之歐洲醫療契約法

Integrating European Treatment Contracts

莊錦秀(Ching-Hsiu Chuang)

《臺北大學法學論叢》 80期 (2011/12) Pp. 1-78

https://doi.org/10.6774/TULR.201112.0003

摘要

全球化經濟活動下，所衍生的複雜多元法律紛爭，須待各國連袂針對超國界契約法統合，而此歐洲醫療契約法，即是基於此歐洲區域法整合歷史潮流下的產物，這樣法規範象徵普通法系及大陸法系國家對醫療契約法能共通接受最大尺度。本文嘗試先從歐洲法域中英德二國有關醫療過失社會背景耙梳整理作基礎介紹；再從整合中歐洲醫療契約法，作一整體性逐條探討，提供關於契約法整合潮流下之歐盟醫療契約法整合之基本資訊。然而，這歐洲區域法整合的醫療契約法，對遠在千里之遙的台灣而言，本身即具吾人深思啟示之處，尤其是個人從目前台灣醫療民事訴訟實證研究資料觀察，漸援引德國實務上發展出「表見證明法則」、英美法上「事實說明自己法則」，來減輕原告之舉證責任，甚至援引德國實務及學說上發展之「重大醫療瑕疵原則」，藉以轉換舉證責任。這些台灣醫療民事實務援引外國實務調整醫療原告舉證責任分配法則，是基於醫患間利益的最佳途徑嗎？如反觀目前英國從2006年NHS補償法案通過，傾向採部分無過錯補償制度，而德國則從最初不採無過錯索賠立場，傾向目前採醫療仲裁（調停）委員會體制（The System of Medical Arbitration Boards）解決醫患索賠糾紛案件，呈現出一個穩定的增加，再從歐洲區域法整合發展著手醫療契約法研究，象徵著現今英德諸國，至少某程度不再堅守循著傳統民事過失責任體系，提供解決醫療民事訟爭唯一方法。這些國際趨勢風向球介紹，是本文撰文目的。

關鍵字

醫療過失 ； 損害 ； 侵權 ； 契約 ； 醫療契約

並列摘要

Complicated and diverse legal disputes deriving from global economic activity require countries to work together in creating a contract law that transcends borders. European medial contract laws are a product of integrating historical trends in the European region; this law signifies the most widely acceptable norm in medical contract laws of countries under common law and the continental law. This study attempted to provide a basic introduction to medical negligence and social background of Britain and Germany of the European jurisdiction, and discussed each article of integrated treatment contract in Europe to provide essential information regarding contract law that integrated current trends of treatment contracts in the European Union. To a far away region such as Taiwan, the integrated treatment contract of the European jurisdiction is worth deep contemplation, especially based on my observation and research in civil litigation for medical negligence in Taiwan, which is gradually using Anscheinsbeweis and res ipsa loquitur in Anglo-American law to mitigate the plaintiff’s burden of proof, even using Germany’s grobe Behandlungsfehlerin practice and theory to transfer burden of proof. Is the reference of foreign practice and adjustment of the plaintiff’s burden of proof in Taiwanese civil suits for medical negligence the best method for doctor and patient? In reflection, Britain’s NHS Compensation Act, passed in 2006, leans towards a no-fault liability confirmation system; Germany, which originally did not take the position of no-fault claims, currently shows an increasing trend of using the system of medical arbitration boards (mediation) to resolve patient claims and cases. Research in integrated development of treatment contracts in European regional law indicates that today’s Britain and Germany no longer strictly follow the traditional negligence liability as the only way to settle medical civil litigation. The objective of this study is to introduce these international trends.

並列關鍵字

medical negligence ； injury ； tort ； contract ； treatment contract

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