醫療刑事責任之明確化與合理化 —以醫療法第82條為中心—

Abstract

近二三十年來社會變遷快速，我國醫療糾紛有顯著增加的趨勢，又由於醫療糾紛常伴隨著損害難以回復、醫療處置的不同選擇、個體生理狀況的多樣性…..等特質，因此隨著媒體的報導討論，醫療糾紛已然成為我國備受爭議的社會議題之一。 觀察我國衛生福利部的統計資料可知，其中關於醫療糾紛的訴訟性質統計，一直都是刑事案件多於民事案件的，而造就如此實務現象的原因，除了有訴訟費用上的考量，更有以刑事案件可能造成的嚴厲判決結果來威嚇醫師進行妥協並賠償的因素存在，此種動輒以刑事方式來處理醫療爭議事件的現象，也間接導致醫師採取防禦性醫療措施與不願投入高風險科別的情形。基於上述的實務情況，醫療領域中的刑事責任便成為許多專家學者所著重探討的主題。 醫療行為的刑事責任討論，在過去已有不少學者提出不同的見解與分析，不過於民國107年新修正的醫療法第82條，其中針對民、刑事「過失」的重新界定，再次讓許多學者與實務界人士提出其各自的看法。故本文以該修法為出發點，重點針對醫療過失的判斷標準及條文中所列舉的其他影響因素，嘗試整理不同學者的批評，佐以實證研究的方法觀察醫療刑事判決的內容，最後提出學生對於此次修法的觀察與建議。

Technology has evolved rapidly in recent decades, especially in the medical field. As getting access to medical services became more easier, the disputes between physicians and patients or the numbers of medical adverse events became a highly debate issue in Taiwanese society. Looking at some statistics data from the Ministry of Health and Welfare, we can know that the numbers of criminal cases are always higher than the civil cases. One of the reasons to that phenomenon was the consideration of litigation costs, another reason was that lawyers and patients tended to file a criminal case to threaten physicians to compensate for their lost when a medical malpractice event happened. But there are some side effects according to that tendency, one of them was the shortage of specialists in some high-risk division. Due to the impact of filing lawsuit against physicians, many experts and scholars have focused on criminal liability in medical field. The discussion about criminal liability in medical field was pretty abundant in the past, but the amendment of Medical Care Act in 2018 has stirred up the discussion once again. Due to the amendment of Medical Care Act article 82 had redefined the interpretation of “Negligence” and set some other factors to considered when judging a medical malpractice case. This thesis will organize opinions to the amendment from different scholars, and try to analyze the impact of this amendment through empirical research.