民事訴訟醫療鑑定之研究

A Study on Medical Expert Testimony in Civil Procedure

曾煥旭(Huan-Hsu Tseng)

指導教授 ： 吳從周

國立臺北大學/法律學院/法律學系一般生組/碩士(2014年)

摘要

本文以我國民事訴訟醫療鑑定制度為研究中心，透過蒐集彙整國內外學者之研究文獻進行與比較分析。期望藉由美國及日本於醫療訴訟鑑定程序之運作情形，檢討我國現行實務於醫療鑑定程序運作上存在之缺失，並提出有效改善我國醫療鑑定之參考建議。
本論文架構共分為六章。第一章說明本論文之研究動機、範圍、所採用之研究方法及論文之架構。第二章主要介紹我國民事訴訟鑑定程序之規定，說明鑑定制度之功能及其目的、鑑定人之義務及權利，並探討鑑定人與證人之不同，試圖明確化鑑定人於民事訴訟程序上之定位。鑒於我國現行醫療訴訟程序，法院主要係委託行政院衛生福利部醫事審議委員會進行鑑定，故第三章將探討我國民事訴訟法上囑託鑑定之規定，並進一步介紹我國醫療鑑定之實務運作情形，並以醫事審議委員會為例，說明其設立過程、組織成員及鑑定流程，檢討該委員會之現行運作模式可能存在之缺失，俾貫徹保障當事人於訴訟程序上之權利。第四章則分別介紹美國及日本於醫療訴訟中鑑定程序運作之情形。就美國之部分，首先依據美國聯邦證據法關於專家證人制度之規定及美國聯邦最高法院對於專家證言容許性之判斷為說明，再進一步分析專家證人於醫療訴訟程序之運用情形及為確保其中立性所採取之相對應措施。就日本之部分，其實務上於醫療訴訟鑑定程序中所採取之方式，如複數鑑定或多人協議之會議式鑑定方法，確實落實日本民事訴訟法鑑定規定原則上以自然人擔任鑑定人之意旨，同時亦加強法院與醫界人士之溝通管道。第五章之重點在於，試圖將前述我國現行醫療鑑定程序之缺失，及外國法上於醫療鑑定程序之運作值得借鏡之部分作一評估及分析。此外為能有效提升醫療鑑定之效率，本文將說明法官應如何於爭點整理程序善用醫學專家，除提供必要之專業知識外，亦能協助法官擬定正確的待鑑定事項，避免重複鑑定之發生。最後，本文探討關於私人鑑定於醫療訴訟之效力及運作，立法院於「醫療糾紛處理及醫療事故補償法」草案第七條訂有「初步鑑定」制度，提供相關管道協助當事人於訴訟前即可取得醫療鑑定報告進而評估其解決醫療糾紛之最佳途徑。因此，本文在此將討論私鑑定於訴訟程序之效力為何，並評估上開草案規定之妥適性及私鑑定於醫療訴訟之運用及所應踐行之法定程序，確實落實我國民事訴訟法關於鑑定規定之意旨並保障當事人之權利。第六章即針對整篇論文之研究，提出本文之想法與意見，期待為我國實務於醫療鑑定程序之運作，提供一臂之力。

關鍵字

專家諮詢 ； 專家證人 ； 醫事審議委員會 ； 醫療鑑定 ； 私鑑定

並列摘要

The thesis focuses on the medical expert testimony in civil procedure. Since expert testimony given by agencies or organizations is widely used in medical litigation, many regulations under the Taiwan Code of Civil Procedure aren’t certainly implemented, which infringe and deprive the parties of their rights during civil litigation. Hence, how to reform and improve the present situation is a vital important topic.
This thesis will interpret the incentive, methodology and scope of this thesis. Chapter two introduces the sections of the Taiwan Code of Civil Procedure relevant to expert testimony, the function and the purpose of expert testimony, and the obligations and the rights of an expert witness. Also the differences between witnesses and expert witnesses will be distinguished so as to clarify the meaning of an expert witness in civil procedure. According to the current medical litigation practice, the Medical Review Board under the Ministry of Health and Welfare is usually designated by courts to provide expert opinions concerning medical malpractice cases. Therefore, the organization of the Medical Review Board and the deficiencies of the operating procedure in the Medical Review Board will be discussed in Chapter three. Chapter four is an introduction of the activity of medical expert witnesses in the medical litigation of America and Japan. In America, many medical boards and professional organizations regulate the qualifications of being a medical expert witness and also establish sanctions to secure the impartiality and objectivity of an expert witness in a lawsuit. Furthermore, the methods of expert testimony that Japanese courts use not only put the principle of the Japan Code of Civil Procedure into practice but also overcome the problems of selecting doctors as medical expert witnesses. In a view of the shortcomings of the medical expert testimony in Taiwan, it is expected that the expert testimony procedure in the medical litigations of Taiwan can be improved through the analyses of and comparisons with the above-mentioned foreign systems.

並列關鍵字

Expert Witness ； Medical Review Board ； Medical Expert Tsetimony ； Technical Adviser

參考文獻

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