我國醫療民事責任之實務發展－兼論法國法對於我國實務之啓發

The Recent Evolution of Medical Responsibility in Taiwanese Civil Law

曾品傑(Pin-Chieh Jseng)

《中正大學法學集刊》 29期 (2010/04) Pp. 69-135

https://doi.org/10.30094/NCCULJ.201004.0003

摘要

本文分析近年來最高法院涉及醫療事故之重要判決，發現在侵權責任法領域，實務上已從消保法第7條之服務無過失責任，回歸到醫療法與民法之過失責任，歸責原則也已自病患合理期待的視角，轉換爲專業醫事人員的標準。惟本文主張基於醫療場所主人責任、以及病患信任醫療診治之法理，醫療機構應就病患發生與住院醫療照護有關之醫療事故，例如基於院內感染、醫院火災斷電、醫療器材故障，或是因醫院所使用之醫藥用品欠缺安全性，致損害病患之生命、身體、健康者，醫療院所應負無過失損害賠償責任。至於在契約責任法之場域，本文發現實務上日趨強調以病患爲主體之醫療取向，不但逐步擴大醫療機構之附隨義務，也漸次樹立醫療院所之試驗義務，加上告知說明義務方興未艾，內容趨於廣泛，實際上不啻形同從過失責任邁向無過失責任。若最高法院有意透過醫療機構近乎無過失之契約責任，來亡羊補牢醫療行爲不適用消保法第7條以後的法制缺憾，本文毋寧是樂觀其成。最後，本文指出醫師基於侵權法上交易安全義務，對於病患所爲告知說明之內容、實施告知說明義務之方式、以及告知說明之義務界線，與醫療機構本於契約法上所爲的告知說明，在義務強度、相對人保護、以及義務範圍等方面炯然有別，病患若欲依醫療民事責任主張權利，則採取醫療機構應負契約責任的救濟途徑，比起追究醫事人員之侵權責任而言，應該較爲有利。

關鍵字

醫療糾紛 ； 醫療機構 ； 企業責任 ； 不完全給付 ； 無過失責任 ； 病患自主決定權 ； 附隨義務 ； 告知說明義務

並列摘要

The purpose of this article, which is divided into four parts, is to analyze the recent evolution of medical responsibility in Taiwanese Civil Law. Following the introduction, Part Ⅱ explains a change in imputation principle concerning medical tort law. Concretely speaking, there is a growing tendency from strict liability to fault liability both in legal policy and in jurisprudence. However, this tendency is contrary to the direction of recent development of French medical responsibility.
Part Ⅲ observes, in the area of medical contract law, an inverse trend from fault liability towards liability without fault. Precisely speaking, Taiwanese Supreme Court imposes contractual obligations on Medical Care Institutions, in order promote the medical service and to protect the rights of the patient. This current strengthens the position of the patient as subject, no more like an object in the relationship of medical care. Part IV concludes by offering some propositions to the development of Taiwan medical responsibility.

並列關鍵字

Medical liability ； Medical care institutions ； Medical personnel ； Informed consent ； Strict liability ； The rights of the patient ； Obligation of the information