本文所關注者乃醫療不作為成立侵權行為之構成要件,透過我國學說與實務見解深入研究,並以醫療實務判決為分析。 緒論首先說明醫療不作為侵權行為之背景、研究目的與範圍,第二章係醫療過失責任之概說,初步描繪醫療糾紛、醫療行為等概念;第三章以侵權行為法理及三層結構為基礎,探究不作為侵權行為之作為義務和醫療作為義務之來源與類型;第四章就英美法與大陸法之法體系差異,因而衍伸出作為義務與注意義務之相關概念問題進行釐清。第五章以我國司法實務之醫療案例為研究對象分析之;最末為結論、建議與展望。 確認作為義務於醫療不作為侵權行為之重要性,乃是基於對行為自由之保護,依我國學說與實務均肯認作為與不作為均得成立侵權行為;論及不作為侵權行為,必須具有「作為義務」為前提。 於侵權行為法上,作為義務屬於行為義務層次,而注意義務則屬於有責性之層次。 將前開概念探究醫療不作為侵權行為,若病方質疑醫事人員未為某特定醫療行為致生損害,則該特定行為是否為應該或必要,即有關之醫療作為義務須加以確認,方能接續檢討違法性與有責性即注意義務之內涵,最後論斷醫事人員責任之有無。要之,侵權行為損害賠償之三階層架構下,作為義務應為判斷不作為侵權行為之核心。 希冀本文之提出對於醫療不作為侵權行為研究有所貢獻,最終仍期待醫事人員之醫療行為自由與病人權益保護,兩者間能有所衡平,以維持醫病關係之和諧。
This thesis is about the medical omission in tort law. Since medical malpractice dispute is serious social problem, many scholars put efforts toward this issue. If the health care providers make mistake actively in medical procedure, the “acts” cause the patient gets medical harm, such as medication error or wrong site surgery accident, it is the type of straight-forwardly infringment. On the contrary, if medical stuff who offense the obligations, but there is no external behavior or act could be observed, how to examine the “act obligations” is a question. For instance, the doctor did not arrange the MRI and the patient find the cancer after a period of time, is it a an unlucky accident or wrongfulness event, should be confirmed. Therefore, This paper aimed to scrutinize the constituent elements of medical omission in tort law, through the theory of German tort law with medical behavior characteristic features, and to research the related medical cases of practice verdict,apply theoretical concepts in a practical context. The thesis is composed of the following six chapters: Chapter 1 is the preface, outline the study background、purpose and the scope. Chapter 2 introduces the medical malpractice related concepts. Chapter3 the main concepts divided to three parts to analyze the issue, which are tort law theory、medical behavior characteristic features in litigation. And we address the problem by these knowledge logically and efficiently. Chapter 4 to clarify act obligations and the duty of care. Chapter 5 Explore the cases by judicial practice. The last chapter is the conclusions.