法學期刊
論著名稱: 醫療糾紛鑑定與對質詰問權(Testimony of Medical Expert Witness on Medical Malpractice and Right of Confrontation)
編著譯者: 張麗卿
出版日期: 2008.10
刊登出處: 台灣/東吳法律學報第 20 卷 第 2 期 /1-28 頁
頁  數: 28 點閱次數: 3264
下載點數: 112 點 銷售明細: 權利金查詢 變更售價
授 權 者: 張麗卿
關 鍵 詞: 醫病關係醫療糾紛醫療鑑定對質詰問權
中文摘要: 近年來,醫療糾紛逐漸增加,醫病雙方的緊張關係也日益升溫。遺憾的是,醫療糾紛實務上之鑑定機制已經受很大的質疑,且被告醫師的對質詰問權也未落實。醫師雖然都是菁英,但也有能力上的極限,加上醫療行為囿限於人體的不可控制性、醫學的有限性,危險的發生在本質上就很難全然排除與控制。
要求醫師對於一切的醫療糾紛承擔責任,包括民事上的損害賠償、行政上的懲戒處分、甚至刑事責任,是嚴苛而不合理的對待。因為過度苛刻的要求,只會讓醫師形成防衛性的醫療,其結果只有讓醫療品質退步,絕非病患之福。所以在醫療糾紛發生後,如何透過科學的刑事醫療鑑定,以及保障被告醫師的對質詰問權,透過理性辯論,發現事實真相,釐清責任的歸屬,是解決醫療糾紛,避免醫病關係陷入對立緊張的唯一途徑。

英文關鍵詞: Doctor-Patient relationshipmedical malpracticemedical expert witnessright of confrontation
英文摘要: Recently, with the increasing of the medical malpractice, the Doctor-Patient relationship becomes more and more difficult. Unfortunately, the testimony of medical expert witness has not been so reliable and the accused doctor’s right of confrontation is not well protected, either. Although Medical Doctors are all excellent, their abilities also have some limitations. In addition, it is very difficult to avoid all the risks of medical practice because of the complexity of human body and the limitation of medical knowledge.
It is not only too strict but also unreasonable to require the doctor assuming all the responsibilities, including the civil compensation for damage, disciplinary disposition, even the criminal penalty, for all kinds of medical malpractices. When such requirements are too strict, it will let the doctor refuse to treat certain patients who are difficult to be cured and the only result is the regress of healthcare quality. Definitely, it is not the expectation of patients. When the medical malpractice arises, the only method to resolve the malpractice dispute and mitigate the difficulty of Doctor-Patient relationship is to determine that who should be responsible after parties’ debate, basing on the scientific testimony of medical expert witness and the protection of accused doctor’s right of confrontation.

目  次: 壹、前言:從象皮症案談起
貳、醫療糾紛鑑定的疑慮
一、醫療知識的不確定
二、鑑定規則不夠完備
三、鑑定結果可能錯誤
四、鑑定內容難以掌握
五、過分依賴鑑定結論
六、以醫審會之鑑定為主
七、以鑑定報告書為裁判依據
參、醫療鑑定報告書與對質詰問權
一、醫療鑑定報告書是傳聞證據
二、醫療鑑定報告書應經對質詰問
三、對質詰問權的法理基礎
四、對質詰問權是憲法保障之訴訟權
五、證人與鑑定人均為詰問對象
六、醫審會的鑑定仍有保障對質詰問權之必要
肆、從保障對質詰問權觀點對醫療糾紛鑑定之建議
一、立法上改採鑑定人到場義務
二、法院應落實鑑定證據審查之「守門員」責任
三、制度上建立專家參審制
四、醫療糾紛鑑定作業之改革
伍、結語

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