Kējì Fǎxué Pínglùn (Jun 2012)
我國醫療上告知說明義務之實務發展 ― 最高法院相關判決評釋 The Development of the Duty to Obtain Informed Consent in Taiwan’s Medical Jurisprudence—A Commentary on Supreme Court Cases
Abstract
本文從醫療上告知說明倫理之法律化出發，透過引介告知說明義務之契約化，以及告知說明義務之社會化議題，刻劃我國醫療上告知說明義務發展的整體容貌。本文首先敘說從古到今醫療誡命的遞嬗變遷，亦即從良知、倫理、到法律的三部曲，其次本文論證侵權法與契約法上之告知說明義務的強度有別，以及告知後同意並不豁免醫療院所抽象輕過失責任的兩個命題，據此闡述告知說明義務之契約化趨勢。此外，本文嘗試從契約上義務群的路徑，導入外行病患之合理期待的思維，並倡議從個別病患之合理期待的視角，判斷未為告知說明與身體健康受侵害間之因果關係，俾據以證立告知說 明義務之社會化現象。 The purpose of this article, which is divided into four parts, is to analyze the recent evolution of obligation of information in medical jurisprudence practice. Following an introduction relative to medical conscience, ethics and law, Part II explores the “contract law” phenomena of obligation of medical information. In one hand, study revealed that, in case of violation of obligation of information, it would be to a patient’s advantage to invoke cause of action of Informed Consent in Taiwan’s contract law, rather than to mention that in Taiwan’s tort law, in order to support his right. In the other hand, it’s important to clarify that medical performance with a patient’s consent can’t exempt the duty of good administrator both for medical care institutions and their medical personnel. Part III argued for a socialization of obligation of information in medical relationship through the acknowledgement of a patient’s reasonable attendance. In fact, the notion of a patient’s reasonable attendance would serve not only as a criterion by which a medical negligence is judged, but also as a standard used for assessing a causation reasoning between a non disclosure of necessary information and a damage of the patient’s bodily right. Finally, Part IV concludes by offering several propositions related to the recent evolution of obligation of information in Taiwan’s medical jurisprudence.
