醫師親自診察義務於醫學倫理及法律之適用

醫師親自診察義務，出於醫學倫理上對於醫師之要求，要求醫師對於病患之診斷必須親力親為，不得假手他人，以追求病患獲得最完善之醫療。我國法律基於此公益之目的，亦將親自診察作為醫師義務明文於醫師法第11條，落實法律保障一般國民權益之意旨。此立法固然具有重要之意義，惟察我國對於醫師親自診察義務之立法條文，除在文義上，經常被法院解釋為醫師必須當場對於病患進行診斷，任何非當場之診斷均有可能構成違反法律之可能，排除遠距醫療之可能。遠距醫療為國際上通用之醫療模式，起源於醫療資源相對不足之彌補，觀察國際上對於遠距診察之應用，除了適用於偏鄉地區外，亦適用於行動不便、需要長期照護或特殊醫療資源相對缺乏之情況，受到廣泛之應用。然而我國除了離島等偏遠地區有可能適用遠距醫療之行政法規之外，在一般情況下，法律並不允許有遠距醫療之醫療行為。此對於醫師進行診斷及病患就醫之權益將有所阻礙，應適度開放遠距醫療，使更多病患獲得就醫之機會。本文針對我國醫師法對於醫師親自診察義務之立法，以及該法律產生之相關問題進行探討，並試圖提出修正建議，以期對於我國之醫療環境能有所助益。

關鍵字

醫師；親自診察；親為義務；遠距醫療

並列摘要

The mandate for prerequisite in-person diagnostics examination derives from medical ethics for physicians, requires physicians to provide in-person diagnosis prior to and treatment, in the pursuit of providing quality care. Seen as public interest, health of the public is protected by law, and thus the Physician Law stipulate in Article 11 that an in-person diagnostic examination must be carried out by a physician before initiating treatment, as to protect the population. Despite its significance, technicality has hindered possible telemedicine practice as the court often interpret said article as requiring physicians to provide on-site examinations for any diagnosis to be made. Any diagnosis not made so may constitute a violation of the law, thus hindering possible telemedicine practice Telemedicine is an internationally accepted model of medicine, first established to meet the needs resulting from inequality of medical resources. Telemedicine is now a global phenomenon, in addition to rural areas, telemedicine is also beneficial to patients with disabilities, patients that need long term care, and regions with specific needs. Despite administrative orders that accept use of telemedicine in remote areas such as outlying islands, in general, current regulation forbids the use of telemedicine. This creates a barrier for physicians to provide diagnosis via established models and has negative impacts on patient rights. In this study, we will discuss the legislation of the Physician Law, specifically articles related to prerequisite in-person diagnostic examinations, and related legal issues. We will also attempt to propose amendments to provide aid to the situation.