Kējì Fǎxué Pínglùn (Dec 2012)
「誰開了這臺刀？」―「告知後同意」法則的精緻化與法學實證分析 “Who Did the Operation?”— Empirical Legal Study and Refinement on “Informed Consent”
Abstract
「告知後同意」為患者自我決定權的具體實踐，然而，「告知內容」的範圍與密度，卻難有一明確標準。若手術主治醫師未經病患同意，而由團隊其他醫師替代主刀，稱為幽靈手術（Ghost Surgery）。雖然手術技巧的實際訓練，對醫學教育的傳承有其獨特重要性；然因病患可能會拒絕較資淺的醫師操刀，而影響教學醫院據實告知的意願；故本文嘗試以此一法益兩難的告知類型，將「告知後同意」的概念再加以精緻化，並與「醫學教育」加以交 錯，將由比較法、醫療準則及實務判決分析，再以實證研究驗證，以充實我國告知後同意體系的內涵。 “Informed consent” is the clinical implementation and expression of a patient’s autonomy. However, it is very difficult to give a definite standard for the scope and the details to be contained in an informed consent. If a surgery was performed by a different operating surgeon without obtaining the patient’s prior informed consent, this conduct could be referred to as “ghost surgery”. While the opportunity to practice clinical skills has a unique role in the surgical education of a young physician, teaching hospitals may hesitate to frankly inform the patient to avoid patient’s refusal to be operated by a trainee physician. Therefore, this article aims to refine the concept of “informed consent” by analyzing this dilemma between medical education and patient’s autonomy. By adopting interdisciplinary studies of comparative laws, medical standards, judicial decisions and empirical * Orthopedic Surgeon of Min-Sheng General Hospital; Attorney at Law; Adjunct Lecturer, National Yang-Ming University; Ph. D. Candidate, National Chiao Tung University Institute of Technology legal verifications, this article seeks to enrich the substance and understanding of “informed consent” in Taiwan.
