論錯誤醫療行為 ─ 以我國相關司法實務判決為中心

Research On Medical Errors ─ Focusing On The Related Judicial Practice Of The Medical Opinions In Taiwan

吳育庭(Yu-Ting Wu)

指導教授 ： 馬躍中

國立中正大學/教育學院/犯罪防治學系/碩士(2012年)

摘要

醫療領域的發展和人體身體健康有著密不可分的關係，隨著近代科技、資訊之急速發展，又以人權意識的抬頭，醫病關係以有別於傳統父權醫療體系的權威模式，而逐漸轉變至以病人為中心之合作模式。這樣的轉變也影響了民眾在面對錯誤醫療案件時，以保障自身權益為積極考量而力求以法律途徑尋求解決，尤其為迫使醫方退讓，我國選擇以刑事訴訟附帶民事請求賠償之訴訟途徑者越來越多，然而考量醫療行為特性，其具有高度之專業性、不確定性與風險性之特殊性質，加以醫療人員從事醫療行為乃出於良善之立意，且醫療人員之培植訓練過程不易，若過度地以高拘束力之相關法規對醫療人員予以規範與介入處理，不僅無法達成保障病患權利的目的，同時對醫方人員來說更有以刑逼民之虞，更可能為了避免招致刑罰而迴避高風險之醫療行為，轉而從事低風險之職，或是對患者治療採取防衛性醫療，此亦非病患之福。
本文以醫師為主要對象，利用德國學者Schroth對於錯誤醫療之三項分類：錯誤醫療之過失行為、醫師告知義務與醫療分工，並加入病患自主權之介紹，以四大範疇進行類型化之實務見解討論分析為內容核心。冀由整理分析我國錯誤醫療之相關學術和司法實務意見，分析錯誤醫療之法律與社會層面觀點，並比較學說和司法實務上判決之差異，提出相關建議，可為日後醫療、司法工作者進一步之參考。

關鍵字

錯誤醫療 ； 醫師告知義務 ； 病患自主權 ； 醫療過失 ； 醫療分工

並列摘要

There is a close relationship between the development of medical field and human health. Coming with the rapid development of modern science and technology, especially the rise of awareness of human rights, the doctor-patient relationship is different from the traditional patriarchal authority of the health care system mode. It has been changed to patient-centered mode of cooperation gradually. The change of the trend has also affected people in the face of the errors of medical cases in order to protect their own rights and strive to seek legal means to resolve. Especially the concessions in order to force the medical side, people increase to choose the criminal proceedings incidental civil claims for compensation litigation. However, considering the special nature of medical practices, with a high degree of professionalism, uncertainties and risks of an exceptional nature to medical personnel in the medical behavior is out of the goodness of conception, and medical personnel to cultivate the training process is not easy, excessively high binding regulations for medical personnel to regulate them couldn’t reach the purpose to protect the rights of patients. To avoid incurring penalties and avoid high the risk of medical practices, the health care professionals may take defensive medical. However it does not benefit patients.
The core focus relies on Schroth’s perspective of three medical error classification, including error medical negligence, the informed consent of physicians’ obligations and the medical division. Then add the areas of patients’ autonomy to the fourth domain of the type of practice insights. The discussion and analysis for the content are the major concern. Furthermore, hope to suggest for future medical, judicial workers further reference by analysis of errors academic and judicial practice of the medical opinions, the Error medical legal and social level view, and compare the judgments of differences in doctrine and judicial practice.

並列關鍵字

Medical Errors ； Medical Obligations ； Autonomy ； Medical Negligence ； Medical Division

參考文獻

張櫻馨(2011)，醫療義務與拒絕醫療權衝突時之刑法評價，國立成功大學科技法律研究所碩士論文。

Dawes PJ, Davison P. Informed consent: Informed consent: what do patients want to know? JR Soc Med 1994;87:149-152.

王成志、楊沛青、李勝揚(2010)，告知後同意與醫病關係的提升－視病“猶親”？醫生真是病人“親密”的朋友嗎？，中華民國家庭牙醫學雜誌，第3卷第2期，頁52-56。

蘇嘉瑞(2008)，知情同意─法律觀點(上)，醫療品質雜誌，第2卷第5期，頁76-79。

蘇嘉瑞(2008)，知情同意─法律觀點(下)，醫療品質雜誌，第2卷第6期，頁86-89。