- 學位論文
地檢署法醫師及檢察官對屍體器官捐贈的經驗、態度及意願的探討
The Study about Experience, Attitude and Willingness Regarding Organ Donation for District Forensic Physicians and Prosecutors
摘要
臺大醫院於1968年完成第一例活體腎臟移植手術，1969年完成第一例屍體腎臟移植手術。器官移植發展至今，已拯救無數人的生命及家庭。儘管器官移植的知識、技術及藥物飛躍地成長，有限的器官來源仍然是不可承受之重。常見增加器官來源的方法如於民眾申請或換發證件時詢問其器官捐贈意願、採用推定同意制及增加心臟停止後死亡器官捐贈來源等。除此之外，由於潛在器官捐贈者的死亡方式多為非病死或可疑為非病死，其須經依法相驗後始能施行器官摘取手術，因此，地檢署及器官移植團隊之間的溝通及合作顯得格外重要。 本研究透過問卷探討地檢署法醫師及檢察官對器官捐贈的意願、態度及知識。地檢署法醫師樣本數為22人，服務年資平均為9.9年，標準差為7.5年；2018年度的不同意率（不同意相驗前摘取器官案件數/捐贈人體器官屍體相驗案件數×100%）為7.1%，服務至今的不同意率則為4.3%；其對器官捐贈的態度皆較正向，知識亦較正確。地檢署檢察官樣本數為25人，服務年資平均為12.2年，標準差為6.8年；其中21人 (84%) 具辦理請求於相驗前摘取器官的經驗，14人 (56%) 具不同意該請求的經驗；不同意的原因依照重要性依序為「影響證據保全、刑事鑑識或解剖鑑定」、「死者的死亡原因或死亡方式」、「醫療機構未提供足夠的相關資料或說明」及「死者的年齡或身分」。檢察機關及器官移植團隊之間應保持良好的溝通及合作，使地檢署在偵查犯罪的同時，亦能完成捐贈者及其家屬的心願，遺愛人間。
並列摘要
From the first successful living renal transplantation in 1968 and cadaveric renal transplantation in 1969 performed at National Taiwan University Hospital, advance in organ transplantation has saved numerous lives and families. However, limited organ resources still pose a serious problem despite the growth of the knowledge, techniques, and medications of organ transplantation. Asking people who apply for or renew their driver license or identification card, introducing legislation to allow for presumed consent and non-heart-beating donation are common ways to increase organ resources. Moreover, since many potential organ donors fall under prosecutor jurisdiction, organ transplant teams can only proceed with the prosecutor’s approval in these cases. Therefore, communication and cooperation between the district prosecutor offices and the organ transplant teams are paramount. The questionnaire applied in this study explored the experience, willingness, attitude, and knowledge of the district forensic physicians and district prosecutors toward organ donation. There were 22 district forensic physicians and 25 district prosecutors attended in this study, with average 9.9, standard deviation 7.5, and average 12.2, standard deviation 6.8 years’ experience, respectively. In this study, the overall denial rate was approximately 4.3%, while the denial rate in 2018 was 7.1%. The main reasons of district prosecutors denied the procurement of organs for transplantation ranked by importance were compromising the preservation of evidence, crime scene investigation, or autopsy, cause and manner of death of the deceased, inadequate information provided by medical institutions, and the age or identity of the deceased, respectively. District forensic physicians not only pose a positive attitude but also have a better knowledge of organ donation. Among district prosecutors, 21 of them (84%) have had decided to remove the organs before the post-mortem examination, while 14 of them (56%) have had denied the request. Conclusively, proper communication and cooperation between the district prosecutor offices and the organ transplant teams are mandatory to fulfill both the legal mandate of the district prosecutor offices and the donors’ wishes to save lives.
參考文獻
延伸閱讀
- 張嘉蘋、葉莉莉、溫敏杰（2002）。急重症護理人員對器官捐贈的態度與知識及其相關因素之探討。慈濟醫學雜誌，14(2)，87-96。https://doi.org/10.6440/TZUCMJ.200204.0087
- 張雅音、林惠娟、謝佳恩、林麗絲、劉貴嬌、陳堯俐（2010）。器官捐贈勸募成功經驗之探討。重症醫學雜誌，11(2)，98-105。https://doi.org/10.30035/TCCM.201008.0003
- 李郁強、趙俊祥（2011）。論屍體器官移植之法規範。法令月刊，62(12)，202-233。https://doi.org/10.6509/TLM.201112_62(12).0009
- 謝佳恩、陳堯俐、林惠娟、張雅音、謝清水（2010）。器官捐贈勸募之探討。台灣醫學，14(1)，26-31。https://doi.org/10.6320/FJM.2010.14(1).04
- 陳聲平、佘振興、程文祺、蘇忠仁（2009）。Preliminary Exploration of the Cognition and Usage of Electronic Databases of Evidence Based Medicine among the Physicians-Experience from a Regional Teaching Hospital。台灣家庭醫學雜誌，19(2)，71-80。https://doi.org/10.7023/TJFM.200906.0071