論醫療事故之刑事過失責任與民事過失責任之差異— 以注意義務與因果關係為中心

A Study on the Difference of the Medical Negligence between the Criminal and the Civil Liability for Malpractice —Focusing on the Duty of Care and the Legal Causation

林宜萱(Yi-Syuan Lin)

指導教授 ： 甘添貴

國立臺北大學/法律學院/法律學系/碩士(2013年)

摘要

醫療訴訟常有不同之刑事與民事判決，且判決結果亦時有分歧，可能有刑事訴訟判決醫師無罪，但民事訴訟卻判決醫師需負損害賠償之情形產生，本文好奇為何同一醫療事故，卻於刑事判決與民事判決結果上會產生差異，故以此為文探討。

對於刑事判決與民事判決之差異，本文以「注意義務」與「因果關係」此二者即過失責任之構成要件，為討論之中心，並就民事與刑事過失責任之規範功能、基本構造、注意義務之內涵、根據、標準以及因果關係的認定、存活機會喪失、說明告知義務、特異體質案例、醫療事故中是否須限於重大過失行為始負刑事責任、個案實務判決評析等與醫療事故相關之問題來比較與討論。

雖民刑事過失責任於規範功能上，有顯著的差異。但民刑事過失責任之基本構造，本文認為是共通的，民事與刑事過失責任之構造，皆同樣分為「注意義務之違反」與「因果關係」，民事過失責任之成立，亦須考量行為人是否對於結果的產生有預見可能性或迴避可能性。而就「因果關係」之部分，因果關係理論不論刑事或是民事，實務上皆是採取相當因果關係理論，其判斷標準並無不同。

是以，民刑事過失責任之成立，有許多相通之處，但由於民刑事責任規範功能等差異，也致使醫療事故上，醫師是否須負民刑事責任之結果互異。例如存活機會喪失理論，本文認為不應將該理論適用在刑事案件上；且，本文亦認為醫療事故中應限於重大過失行為始負刑事責任，若非重大過失，以民事及行政責任來處理，似較為妥適等。

本文以醫療事故中之刑事過失責任與民事過失責任之相同與相異之處作為研究之方向，希冀能對醫療事故之民刑事過失責任的異同之問題上，提出一些可以探討的議題，並有助於釐清該二者之差異。

關鍵字

醫療事故 ； 刑事過失責任 ； 民事過失責任 ； 注意義務 ； 因果關係

並列摘要

Medical lawsuits often file for criminal and civil prosecution, and the judgments often result in different consequence. There may be criminal proceedings announce the doctor is not guilty, but the civil proceedings announce the doctor have to compensate the patient for their damages. I’m curious about why the same incidents but in criminal conviction and civil verdict will result in different consequence, so I discussed for the text.

For the differences from the criminal convictions and civil judgments, this text is focused on the "duty of care" and the "legal causation" because those two are the constituent elements of the liability for malpractice. The text is also involved in the normative functions and basic structure of the civil and criminal liability for malpractice, the connotation, foundation, standard of the duty of care, how to determine the legal causation, the loss of chance of survival, the duty of disclosure and notice, idiosyncratic cases, if the medical criminal liability for malpractice shall be limited to gross negligence, analysis of practice cases, and issues related to medical negligence.

Although there are significant differences in the normative functions between the civil and criminal liability for malpractice, the basic structure of the civil and criminal liability for malpractice is common. The structure of the civil and criminal liability for malpractice is also classified as "the violation of the duty of care" and" legal causation ". The establishments of the civil liability for malpractice also have to consider whether the person who makes the juridical acts can have foreseeability and preventability about the results. On the "legal causation" part, criminal or civil proceedings are all taken the proximate cause theory in judicial practice, and its criteria are not different.

Therefore, the establishments of civil and criminal liability for malpractice are so similar. But the normative functions of the civil and criminal liability for malpractice and others are different, and result in different consequence of civil and criminal judgments in medical negligence. For example, the loss of chance of survival theory, this text considers the theory was not applicable to criminal matters. And, this text also considers the medical criminal liability for malpractice should be limited to gross negligence, if the case is not about gross negligence, it seems more better to use civil and administrative liability to deal with.

In this text, the similarities and differences of the medical negligence between the criminal and the civil liability for malpractice are the research direction, hoping to be able to raise some of the issues which can be explored and clarify the differences between the criminal and the civil liability for malpractice on the medical negligence.

並列關鍵字

medical negligence ； criminal liability for malpractice ； civil liability for malpractice ； the duty of care ； the legal causation

參考文獻

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