醫療機構之永續發展-以醫療機構面對醫療糾紛之法制為例

Medical Institution's Sustainable Development- An Example of A Legal Structure When Medical Institution Faces Medical Malpractice

張婷(Ting Chang)

《臺灣災害管理研討會》 2014 (2014/11) Pp. 471-503

https://doi.org/10.6857/CDMT.201411.0039

摘要

依據「醫療法｣第2條規定，所謂醫療機構係指供醫師執行醫療業務之機構而言。又依據同法第12條規定醫療機構又依據設置目的之不同，區分為醫院、診所與其他醫療機構。醫療機構雖與一般企業有異，非以營利為唯一目的，具有公益性質，然，其與企業相同皆以追求永續發展為發展宗旨之一。本文依據全球永續報告協會最新於2013年5月發布之永續報告指南第四版（G4）為研究範圍。針對其中一般標準揭露與特別標準揭露，共計14大指標與153個具體指標，檢視當今台灣醫療機構在永續發展面向之法規面建置完備性與發展適宜性。再者，台灣除參考國際永續發展標準G4外，已施行多年之醫院評鑑基準及評量項目與衛生福利部為落實企業社會責任所制定之2013永續發展社會責任報告書亦一併進行比較。台灣社會現今瀰漫醫療糾紛亂象，為緩和醫病關係，本文認為醫療機構進行永續發展考量與布局時，醫療糾紛之因應與機制設置為不可忽視之觀察指標。面對「病人輸、醫事人員輸與有限司法資源輸之三輸格局｣，本文認為無論依據國際或國內永續發展之標準，台灣醫療機構在角色定位上，須態度積極介入、立場客觀中立與落實專業協助；在權利義務方面，醫療機構「說明、溝通、協助及關懷服務」亦須真正釐清事實與滿足情感需求。面對醫療機構落實程度、成本增加與責任主體之困境，醫療機構在挑戰上亦須克服倫理爭議及進行衝突管理。在醫療機構永續發展之道路上，降低醫療糾紛與發展國際醫療不失為機會選項之ㄧ。

關鍵字

永續發展 ； 永續報告指南第四版 ； 企業社會責任 ； 醫療糾紛 ； 醫病關係

並列摘要

According to Article 2 of the ＂Medical Care Act＂, medical care institution means any institution in which physicians conduct the practice of medicine. In Article 12, medical care institutions can be differentiated into hospitals, clinics, and other medical care institutions based on different purposes. Although medial care institutions are different than enterprises, making profit isn't the only goal, but has a public nature. Pursuing for sustainable development is one of the development purposes which are the same as enterprises'. The study scope of this article is the Sustainability Reporting Guidelines (G4) lately initiated in May 2013 by the Global Reporting Initiative. Totally, there are 14 main indicators and 153 detailed indicators including general standard disclosures and specific standard disclosures. This article attempts to examine Taiwan's medical care institutions' completeness and suitability legally in the process of sustainable development. Furthermore, except G4, hospital accreditation basis and assessment item and 2013 sustainable development and social responsible report, initiated by the Ministry of Health and Welfare, are both compared. Medical malpractices are common nowadays in Taiwanese society. To maintain doctor-patient relationship, setting up a mechanism for resolving medical malpractices is an indispensable indicator when medical care institutions are planning for sustainable development. Facing a situation when Taiwan's patients, doctors, and limited judicial resources all lose, this article considers that medical care institutions' roles are the following: attitudes should be aggressive, standpoints should be objective, and professional assistance should be fulfilled, no matter based on international or local sustainable development standards. In the aspect of rights and obligations, medical care institutions' explanation, negotiation, assistance, and caring services should truly fulfill facts clarity and emotional needs. Facing medical care institutions' dilemma of implementation degrees, increasing cost, and being the main responsibility body, medical care institutions also have to face ethic disputes and conflict managements challenges. On the road of pursuing sustainable development, decreasing medical malpractices and developing international medical care are both choices for medical care institutions to choose.

並列關鍵字

Sustainable Development ； Sustainability Reporting Guidelines 4 ； Corporate Social Responsibility ； Medical Malpractice ； Doctor-patient Relationship