醫療機構組織責任之探究

醫療傷害事件之發生，有時並非醫護人員之過失所致，或雖為醫護人員之過失所致，惟其背後主因乃醫療機構之系統性錯誤所致，法院於追究此等責任時，箭頭通常指向個別醫護人員，忽略於追究醫療機構系統性錯誤之責任。又醫療機構乃係基於受僱人過失責任始負僱用人連帶賠償責任，或基於履行輔助人過失責任而負債務不履行責任。然而於部分類型之醫療傷害事件，個別醫護人員之過失責任難以確認，於此情形，醫療機構毋庸負責，可能造成病人求償之漏洞。交易往來義務係針對民法第184條第1項前段不法侵害他人權利構成要件之具體化。德國實務逐漸強調醫療機構組織義務為交易安全義務之一重要類型，並使醫療機構對其系統性錯誤所造成之病人損害結果負獨立賠償責任。於我國，以醫療機構組織義務為立論基礎而課予醫療機構獨立賠償責任之判決，實為罕見。本文擬藉由評析「器材故障案」與「病人走失案」之歷審法院見解，凸顯我國法院過於強調醫護個人責任而忽略於論斷醫療機構組織責任之缺失，期待未來法院於系統性錯誤所致之醫療傷害事件的究責上，能從醫療機構組織義務之基礎立論，以民法第184條第1項前段規定為依據而令醫療機構負獨立之賠償責任，始不至於發生病人求償無門之憾事，又有助醫護人員過失責任之合理化。

關鍵字

交易安全義務；醫療機構組織義務；行為義務；注意義務；護理人員

並列摘要

The medical malpractice is sometimes not caused by the nurse's negligence. Or, the medical practice is sometimes caused by nurse's negligence, but it is actually caused by the error of hospital organizational behaviors. In the opinions of courts, the health professionals, not hospital, are liable for the damage of patients. As an employer, hospital usually has joint liability with employee. However, in some cases, hospitals are not necessarily liable because the liabilities of health professionals are not easily identified. Transaction security obligation is covered in section I of Article 184, and in the German the hospital organizational obligation is one type of transaction security obligation. Furthermore, in the German, the hospital has its liability for the damage of patients due to hospital organizational obligation. In Taiwan, the judgment emphasizing on hospital organizational obligation is rare. The purpose of this article is try to point out that the court fails in emphasizing the hospital organizational obligation, by analyzing the case of equipment broken and case of patient missing. Hopefully, in the future, the court could emphasize the hospital organizational obligation in order to appropriately compensate the damage of the patients and establish the reasonable liabilities of the health professionals.