醫療糾紛民事責任與無過失補償制度之研究

The Research on Civil Liability of Medical Malpractice and NO-fault Compensation System

黃國宸(Guo-Chen Huang)

指導教授 ： 林誠二

國立臺北大學/法律學院/法律學系/碩士(2013年)

摘要

本文研究之目的在於探討如何填補醫療過程中所發生之損害。蓋，根據數據統計，我國醫療糾紛案件數量有逐年升高之現象，而醫療糾紛之發生即係因醫療過程中發生醫療傷害，且醫病雙方對於該傷害之責任歸屬有所爭執，此即醫療糾紛。傳統上，醫療糾紛之民事責任係以過失責任為主，而其中爭議在於訴訟上醫療過失舉證責任如何分配，以及醫療過失應如何判斷等，然而在消費者保護法施行後，發生醫療行為是否適用消保法服務無過失責任之爭議，再者，又有醫療行為是否適用民法第191條之3危險責任之爭議，上開爭議，皆值得本文深入探討。最後，近來不斷被提及之醫療無過失補償制度，則係一可能與傳統民事責任互補之制度，故亦有探討之必要。另外，關於本文參考之文獻，主要係以我國與外國之學術著作、期刊論文、碩博士論文以及實務判決等作為架構之基礎，並輔以外國立法例，如日本法以及美國法作為比較法上之不同視野借鏡。本文共分為六章：第一章為緒論。第二章為醫療行為、醫療糾紛與醫療關係，探討並釐清相關概念。第三章為我國醫療民事責任規定，介紹因醫療行為所生之民事上損害賠償責任。第四章為醫療過失之判斷，整理醫療過失判斷之標準，包括醫療慣例、醫療準則與醫療常規等，以及日本法之醫療水準論與美國法之理性醫師注意標準，並評析我國醫療過失之相關案例。第五章為無過失補償制度之介紹，並評估我國現行環境下是否有實施醫療無過失補償制度之可行性。第六章為結論。

關鍵字

醫療糾紛 ； 醫療過失 ； 醫療常規 ； 醫療水準論 ； 無過失補償制度

並列摘要

The aim of the thesis is to investigate how to fill the damage having occurred in medical procedures. According to statistics, there is a phenomenon that the numbers of medical malpractice has been increasing year by year in Taiwan. Medical malpractice means a medical injury occurred in medical procedure, and the doctor and the patient both dispute the responsibility for the injury caused during medical procedure. Traditionally, civil liability of medical malpractice is based on fault liability, which concerns the issue of how to distribute the burden of proof in those medical lawsuits, as well as how to determine the medical negligence. However, there is a dispute as to whether the medical services should apply the services strict liability of Consumer Protection Act after Consumer Protection Act enforce or not. Furthermore, another dispute over whether medical services should apply the liability of dangerous activity or not (article 191-3 of Civil Code). The above is worthy of deeper research. Finally, the system mentioned recently is medical no-fault compensation system, it may be complementary with the traditional civil libility system. Therefore, further investigation toward this issue is a must. In addition, main references in this thesis are academic books, journal articles, dissertations, and practical judgments from both Taiwan and foreign countries. Other parts are supported by foreign legislation cases, such as Japan and the U.S. as comparative law references. This thesis is divided into six chapters, the first chapter is the introduction. The second chapter is about the medical practice、medical malpractice and medical relation, and clarify related concepts. The third chapter is about medical civil liability provisions, introducing the civil law liability because of medical acts. The fourth chapter is about the judgments of medical negligence, and sort out the judgment criteria of medical negligence, including customary medical practice and medical guideline, as well as the theory of Japanese medical standard and the United States reasonable physician standard care. The chapter five introduces medical no-fault compensation system and evaluates whether the feasibility of the system can be applied under current circumstances. The sixth chapter is the conclusion that summarizes the mean ideas of this essay.

並列關鍵字

medical malpractice ； medical negligence ； customary medical practice ； the theory of medical standard ； no-fault compensation system

參考文獻

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