醫師告知義務法律責任之再研究- 以是否負刑事責任為中心

An Empirical Study On Physicians' Leagal Liability of Disclosure - A Closer Look at Criminal iability

邱琪雯(Chi-Wen Chiu)

指導教授 ： 雷文玫

中原大學/商學院/財經法律研究所/碩士(2006年)

https://doi.org/10.6840/cycu200600052

摘要

摘要
本論文之所以探討醫師告知義務之法律責任為研究之主題，主要是因為醫學臨床實務上，許多的醫療糾紛均起因於醫師未履行告知義務或告知不完全，甚至因而被認為是傷害行為。因此，醫師在為醫療行為前對病患告知並取得病患之同意，即相當重要。惟此一觀念在過去傳統父權主義的醫療模式下並不受到重視，直到近代病患自主權提升後才有所改善。然而，病患的同意與「告知後同意」仍有程度上的不同。究竟應具備何種要件始得謂醫師已取得病患之告知後同意？醫師若有違反時，應負何種行政、民事、刑事上責任，始足以保障病患此一權利？均為本論文所討論的重點。
此外，鑑於醫療過失應否除罪化此一爭議存在由來已久。本論文將以醫師違反告知義務時之刑事責任，作為研究之重心。當醫師未告知即對病患進行手術，致發生死亡或不可逆的傷害結果時，在刑法上應如何評價？是故意行為？或過失行為？且是否應如同英美法系將過失區分為普通過失、重大過失，使醫師不至於僅因普通過失，在未達於重大過失時即構成刑法上犯罪。本文對此從實務及比較法的觀點進行討論，認為應採取折衷的考量。亦即，醫師違反告知義務在符合過失犯的成立要件下，仍有負刑事責任之可能，惟無庸再區分普通過失或重大過失。如此，不僅可避免醫師動輒成立刑法上犯罪，亦可適當提升醫師應有之注意義務。

關鍵字

醫病關係 ； 侵入性醫療行為 ； 手術同意書 ； 醫療過失 ； 告知後同意 ； 病患自主權 ； 醫師告知義務

並列摘要

Abstract
Several cases of medical malpractice in clinical medicine are due to physicians’ failing to fully inform medical procedures to patients. This study examines the legal responsibility of physicians’ duties of disclosure. It is critical that physicians obtain consent of agreement from patients before performing medical procedures. The concept of fully disclosure is not prevalent under paternal medical modern until the rising of patients’ autonomy. It is also important to determine the process of fully disclosure and distinguish the difference between “consent” and “informed consent”. This article further studies physicians’ administrative, civil, and criminal liabilities when fail to perform duties of disclosure.
Furthermore, it has long been controversial whether to decriminalize malpractice in clinical medicine, this study focuses on criminal liability when physicians fail to perform duties of disclosure. For instance, how do we evaluate when physicians perform medical procedure without obtain patients’ informed consent? Is this Intentional or negligence behavior? Common law system categorizes negligence into negligence and culpable negligence. By doing so, physicians are not subjective to criminal liability due to negligence but only culpable negligence. I discuss the above from legal practice and comparative study’s point of views. I argue that adopting a midpoint position is necessary to examine the issue. Which means, a physician who breaches his/her duty to notice can be held criminally responsible if negligence is found. However, it’s not necessary to distinguish negligence and culpable negligence. In this case, physicians will not be subjective to criminal liability easily but physicians’ duty of care could also be promoted further.

並列關鍵字

Medical Malpractice ； Doctor -Patient Relationship ； Physicians' Duty of Disclosure ； Invasive Intervention ； Patients' autonomy ； Informed Consent

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