探討使用機器人為手術時醫療機構與醫事人員之僱用關係

Discussing the Employment Relationship between the Medical Institutions and Medical Personnel when Using Robots for Surgery

鄭匡善(Cheng, Kung-Shan)

《軍法專刊》 68卷2期 (2022/04) Pp. 142-189

摘要

機器人外科手術輔助系統已吸引國內外諸多醫療機構採用，不過當前僅少數國家准許以其進行遠端手術。當手術醫療機構邀請他醫療機構派員現場或遠端支援手術，該應援醫事人員是否與該受援醫療機構或應援醫療機構成立僱用關係皆引發爭議。本文彙整判定僱用關係的當前各種標準，刪除其中諸如套套邏輯表述等問題。本文發現援引醫療法令作為實質客觀證據，更容易判定僱用關係，且判定結果與通說實質客觀標準相同。雖然傳統上認為使用表見客觀標準判定僱用關係有利於原告舉證，本文發現該標準判定醫療僱用關係結果反而更不利於受害原告，尤其涉及遠端提供服務者。既然遠端提供服務之方式可預期隨科技發展更興盛，本文發現有必要為遠端勞務受害原告研究證明僱用關係之更有效舉證方法。

關鍵字

支援 ； 選任 ； 監督 ； 客觀標準 ； 多數僱用人

並列摘要

The robotic-assisted surgical system has attracted adaptation by many medical institutions worldwide; however, currently, only a few countries have authorized its use for remote surgery. Whether the medical practitioners called for help having an employment relationship with the medical institution calling for help and with the one offering the help raises disputes when a medical institution invites the medical practitioners of another medical institution to help in situ or remotely the robotic surgery. This article collected and re-organized the current theories of the standard used for determining the employment relationship and removed some problems of them, such as the use of the tautological expression. This article also analyzed and discussed the feasibility of introducing the relevant rules of the laws and regulations in medicine to the standard for determining the employment relationship, and then compared the results of using this new standard and those using the traditional ones. This article found that using the relevant rules of the laws and regulations in medicine as substantial objective evidence could determine the employment relationship more easily and the results determined were the same as those using the traditional dominant standard, the substantial objective standard. Though traditional belief thought that using the superficial objective standard would be more beneficial to the claimant for proving the employment relationship, this article found otherwise, the results using this standard to determine the employment relations of the aforementioned new situations all disfavor the claimant, especially those situations involving providing services remotely. Since it is expected that providing service remotely would become more and more popular with the improvements in technologies, this finding suggests that the claimants of this type of litigation would need to develop more effective strategies for proving the employment relationship.

並列關鍵字

Support ； Selection and Designation ； Supervision ； Objective Standard ； Multi-Employer

參考文獻

J. Marescaux et al., Transatlantic Robot-Assisted Telesurgery, NATURE, 413(6854), 2001, 379-380.

T. Hassan et al., Al-Zahrawi: A Telesurgical Robotic System for Minimal Invasive Surgery, IEEE SYSTEMS JOURNAL, 10(3), 2016, 1035-1045.

I. Mendez et al., Robotic Long-Distance Telementoring in Neurosurgery, NEUROSURGERY, 56(3), 2005, 434-439, p. 434.

H. Sebajang et al., The Role of Telementoring and Telerobotic Assistance in the Provision of Laparoscopic Colorectal Surgery in Rural Areas, SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 20(9), 2006, 1389-1393

健保署，〈達文西手術申報問答輯〉，第 1 版，2019 年 4 月 15 日。