刑事過失責任之探討：以美國刑事醫療案例為例

A Discussion on Criminal Negligence: Based on Criminal Cases of Medical Malpractice in the United States

張明偉(Ming-Woei Chang)

《臺大法學論叢》 39卷1期 (2010/03) Pp. 353-401

https://doi.org/10.6199/NTULJ.2010.39.01.07

摘要

台灣醫師在遭遇醫療糾紛時，往往在無法與病患或其家屬達成和解時需面對刑事訴追，醫界相當不滿醫療過失犯罪的定罪率高居不下，並主張將醫療糾紛除罪化。為回應前述醫界之主張，本文在參考美國法概念後，主張我國法界應重新定義刑事過失之內涵，美國法界普遍承認並非－偏離注意義務或行為義務即該當刑事過失。然而長久以來，台灣學術界與實務界均認為只要偏離注意義務即該當刑事過失，因此所有的民事過失均該當刑事過失。本文認為我國有關刑事過失內涵之觀點存在與民事過失混淆之不當，蓋其制度目的原有不同也。因此，本文主張參考美國刑事過失之內涵以重新定義我國刑事過失之概念。果如此，則醫師因醫療糾紛被起訴、甚至被定罪的案例將大大減少。

關鍵字

醫療糾紛 ； 除罪化 ； 重大過失 ； 致死罪 ； 注意義務 ； 偏離 ； 可歸責性 ； 不道德 ； 輕率 ； 故意

並列摘要

In Taiwan, a criminal prosecution of criminal negligence goes for medical doctors especially when the medical malpractice is not settled. Medical doctors are much dissatisfied with high conviction rates and argue for decriminalization of medical malpractices. In response to this argument, this article tries to redefine the term ”criminal negligence” by referring to American concept. After analyzing cases about criminal prosecution of medical doctors in the United States, this article concludes that not all deviation from standard of care or standard of conduct would result in criminal negligence. However, the situation in Taiwan is very different. The courts and scholars in Taiwan almost agree that criminal negligence equals to civil negligence so all deviation from standard of care or standard of conduct would be covered in criminal negligence. The article argues the Taiwanese viewpoint confuses criminal negligence with civil negligence. In support of saying that, this study distinguishes the former from the latter by pointing out the legislative concern of each concept. As a result, this study suggests adoption of the American idea of criminal negligence, which makes a better sense, would limit the scope of criminal negligence in Taiwan. Only few medical malpractices then will go under criminal prosecution.

並列關鍵字

medical malpractice ； decriminalization ； gross negligence ； manslaughter ； standard of care ； deviation ； culpability ； wanton ； reckless ； intent

參考文獻

中時電子報網站

中國時報(2008/01/2l)

王宗倫、蔡墩銘、蔡正河()。

台北市政府衛生局保健網網站

博士明師中醫網站