簡評專科護理師解釋病情與書寫醫療紀錄之法源－兼論兩刑事裁判

Discussion of Nurse Practitioners' Legal Standing Regarding Explaining Patient Condition and Writing Medical Records: With Two Examples of Criminal Judgments

邱慧洳(Hui-Ju Chiu)

《台灣專科護理師學刊》 1卷1期 (2015/02) Pp. 43-49

摘要

依據醫師法第二十八條，非具醫師資格者，執行醫療業務，則觸犯密醫罪，惟護理人員在醫師指示下執行某些醫療業務，可例外不論以密醫罪。本文將介紹兩刑事裁判，藉以探究專科護理師執行解釋病情與書寫醫療紀錄等醫療業務是否觸犯密醫罪。衛生福利部所作之行政函釋雖指出專科護理師得協助醫師解釋病情與書寫醫療紀錄，然而以行政函釋規範專科護理師之執業範圍存有兩缺失：第一，行政函釋對法官認事用法並無拘束力；第二，行政函釋若牴觸法律則無效，故而以行政函釋規範專科護理師之執業範圍對專科護理師工作權益保障似乎不足。為避免專科護理師觸犯密醫罪，應以法律或授權命令規範專科護理師之執業範圍，本文將介紹「預防接種修法模式」，並建議以此例作為專科護理師執業範圍立法之參考依據。

關鍵字

專科護理師 ； 解釋病情 ； 書寫醫療紀錄 ； 醫療業務 ； 法律

並列摘要

According the Physician Act Article 28, if people who are not physician implement medical behaviors, they would offend the ＂fake-doctor crime＂. However, nurses who implement medical behaviors under doctors' order would not offend the ＂fake-doctor crime＂. This article would introduce two criminal judgments, which explore whether nurse practitioners who help physicians to implement such medical behaviors as explaining patient condition and writing medical record offend the ＂fake-doctor crime＂. The Direction made by Ministry of Health and Welfare indicated that nurse practitioners could help physician to explain patient condition and write medical record. However, governing the scope of practice of nurse practitioners by using the Direction mentioned above is insufficient, due to the two reasons as follows: first, the judge may refuse to apply the Direction if the Direction is not applicable to the case. Second, the Directions that are in conflict with laws shall be void. Therefore, the scope of practice of nurse practitioners stipulated by the Direction mentioned above is insufficient for protecting the rights of nurse practitioners. To avoid offend ＂fake-doctor crime＂, the scope of practice of nurse practitioners should be stipulated by a statue or ordinance. This article would introduce ＂the Vaccine Legislative Model＂, which could serve as a good model for the legislation for the scope of practice of nurse practitioners.

並列關鍵字

nurse practitioners ； explain patient condition ； write medical record ； medical behaviors ； law

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