醫療糾紛案件處理之探討-以台灣醫療改革基金會收案對象為例

A Study on Medical Malpractice Case Filed to the Consumers’-The Case Study of Taiwan Health Reform Foundation

鄭志忠(cheng chih chung)

指導教授 ： 林恆慶

臺北醫學大學/公共衛生暨營養學院/醫務管理學研究所/碩士(2003年)

摘要

本研究為瞭解曾經遭遇醫療糾紛民眾之相關醫療經驗，與其對醫療糾紛發生原因之看法，並探討分析影響民眾處理醫療糾紛案件之相關因素。此研究以台灣醫療改革基金會受理之醫療申訴個案（民國九十一年三月以前）為對象，進行郵寄問卷調查。共寄發一九一份問卷，得有效問卷為一○九份，回收率為五七%。本研究重要結果如下： 一、 在受訪者醫療糾紛經驗方面，發生最多科別為外科，其次為內科、婦產科及小兒科。在受訪者認為所受主要醫療傷害或損失上，以病人死亡（45.9%）及重傷（37.6%）為大部份。 二、 醫療過失行為實為醫療糾紛發生原因的主要重點，其次為醫師的告知義務，在醫師告知義務上又以未告知治療上併發症或副作用為主要因素。 三、 在醫療糾紛發生時，有大部份的受訪者建議直接向當事人反應或是直接向醫院負責部門反應，於是在醫院管理上建立良好的申訴通道是有其必要姓。 四、 在尋求社會有力人士（黑道）出面上，仍有18%受訪者建議此解決方式;另有在尋求司法途徑方面（律師、民事、刑事）有64%~83%的受訪者建議採取。 五、在醫療糾紛案件的處理上，醫療過失行為是引發法院訴訟的主要因素之一，再者就是醫師實施手術或麻醉時未讓病患或其家屬簽手術同意書，則會可引發受訪者尋求社會有力人士（黑道）協助與採取自力救濟等處理方法。 本研究最後討論研究限制，並建議未來研究方向，以提供社會各界參考。

關鍵字

醫療糾紛

並列摘要

This study is made in order to understand related medical experiences of the public who have encountered disputes regarding medical treatment, and their opinions about the reasons of disputes occurred, moreover, explore and analyze relevant factors, which affects the public dealing with the disputes of medical treatment. This study takes complaining cases (before March 2002) accepted by Taiwan Health Reform Foundation as objects to carry out questionnaire via mail. Total 191 copies of questionnaire were sent, and effective ones were 109, return ratio 57%. The important results of this research are as follows: 1. With respect to the interviewees’ experiences on disputes of medical treatment, the most disputes were occurred in surgery department, next medical department, obstetrics & gynecology department and pediatrics department. With respect to the injury or lose due to medical treatment, most were in death of patient (45.9%) and severe wound (37.6%). 2. Mistake of medical treatment is the important reason of disputes with respect to medical treatment, next is doctor’s notice obligation; in doctor’s notice obligation, the most are not to advise the complication or side effect of treatment 3. When the disputes of medical treatment occurs, most interviewees recommend to directly respond to party concerned or responsible department of hospital. Therefore, to establish a good channel for complaint in hospital management is necessary. 4. With respect to seeking powerful persons (gangs) in society for solution, 18% interviewees still recommended; with respect to seeking the way of jurisdiction for solution (attorney-at-law, civil and criminal action), 64%~83% interviewees recommended to use. 5. With respect to dealing with disputes of medical treatment, the mistake of medical treatment is one of the main factors to produce lawsuit, next is when doctor enforcing operation or anesthesia did not allow patient or her/his family to sign a letter of consent that probably results in interviewees to seek powerful persons (gangs) in society for help and adopt self-remedy. Finally, this study discusses the limit of research and recommends the future research in order to provide references for every circle of society.

並列關鍵字

Medical Malpractice

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