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論著名稱: 醫療法第 82 條的修正與疑慮:以醫療糾紛拔牙案為例(The Amendment of Paragraph 82 of Medical Care Act and Its Doubts: Focus on the Extraction Case in Medical Lawsuits)
編著譯者: 張麗卿
出版日期: 2018.07
刊登出處: 台灣/月旦醫事法報告第 21 期 /86-111 頁
頁  數: 17 點閱次數: 987
下載點數: 68 點 銷售明細: 權利金查詢 變更售價
授 權 者: 張麗卿
關 鍵 詞: 牙科醫療糾紛合理臨床專業裁量刑事醫療過失醫療上必要注意義務醫療法第 82 條
中文摘要: 本文以一則相當尋常的牙科診療所涉的刑事醫療糾紛為討論主題。病人主張,牙醫師明知其罹患牙周病,屬於齲齒之高風險群,在就診期間從未以X光進一步檢查,而有違反醫療法第 82 條之規定。根據醫事審議委員會的判斷,該牙醫師違背了必要注意義務,不但逾越了合理臨床專業裁量,亦無臨床專業裁量權限的例外情況而有疏失。然而,違反必要注意義務,逾越合理臨床的裁量,還不必然有刑法上的過失。注意義務的違反與臨床専業裁量照傷害結果之間的因果關係仍需進一步檢視。根據醫療法第 82 條,成立過失犯罪的條件必須是「違反必要注意義務」,且「逾越合理臨床專業裁量」,而法院仍必須仔細斟酌刑法上的原則,對於醫療事故進行判斷其間是否具有内在的關聯性,方能成立刑事之醫療過失。
英文關鍵詞: medical lawsuits of dentistrythe reasonable exercise of professional clinical discretioncriminal medical negligencemedical due careparagraph 82 of Medical Care Act
英文摘要: By introducing a normal case, the topic in this article would be the criminal medical lawsuits of dentistry. The patient accused the dentist about a breach of paragraph 82 of Medical Care Act that he didn't take any X-ray to have a further examination during the visiting, while he knew that the patient had a periodontal disease, which lead to decayed tooth with high risks. According to the identification by Medical Review Committee, the dentist breached medical due care; and exceeded the reasonable exercise of professional clinical discretion without any exception. He had a medical negligence as the consequence; nevertheless, a medical negligence doesn't lead to a criminal negligence. The causality between the breach of medical due care, professional clinical discretion and injury as the consequence should also be considered. According to the paragraph 82 of Medical Care Act, the conditions of the criminal medical negligence are a breach of medical due care and exceeding the reasonable exercise of professional clinical discretion. Furthermore, the court should examine the medical lawsuit, according to the principles of Criminal Law, whether there was an immanent coherence between the behavior and the injury to confirm a criminal negligence.
目  次: 壹、前言
貳、牙科醫療糾紛的特色
一、牙科醫療糾紛多涉及密醫犯罪
二ヽ牙科醫療糾紛多發生於診所
三、常見牙科醫療糾紛類型
參、拔牙案的爭執
一、醫師之抗辯
二ヽ醫事審議委員會鑑定意見
肆ヽ醫療法第 82 條修正刑事責任的認定
一、刑事醫療過失的判斷與問題
二、醫療法第 82 條的修正脈絡
三、醫療法第 82 條的新規定
伍、回到拔牙案
一、新法的運作模式
二、本案適用新法的疑慮
陸、結語
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