法學期刊
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論著名稱: 【醫療刑事法】心導管葉克膜案:概然性與結果歸責
編著譯者: 蔡聖偉
出版日期: 2019.09
刊登出處: 台灣/月旦醫事法報告第 35 期 /58-79 頁
頁  數: 14 點閱次數: 359
下載點數: 56 點 銷售明細: 權利金查詢 變更售價
授 權 者: 蔡聖偉
關 鍵 詞: 注意義務違反關聯性風險升高理論風險實現違反注意義務概然性估算
中文摘要: 醫師為病人實施心導管手術時,須事先安排葉克膜裝置及團隊,以確保一旦發生併發症,可在 20 分鐘內得到該團隊的支援救助。若醫師在沒有事先安排的情形下實施心導管手術,即屬違反注意義務,製造了不受容許的死亡風險(即便目前並無任何成文法規對此設有明文要求,亦然)。然而,在心導管手術中發生併發症時,縱使及時使用葉克膜施以急救,仍有高達九成的死亡率。因此,死亡結果出現時,由於欠缺義務違反關聯性,便難以將該結果歸咎於未安排葉克膜團隊支援的義務違反行為。換句話說,本案被告施行心導管手術雖然製造了不受容許的死亡風險,但由於不能認定該死亡結果確係此風險所引起,故無法肯定結果歸責,不成立過失致人於死罪。
英文關鍵詞: relevance of obligations violationtheory of risk elevationrisk realizationviolation of duty of careprobability estimation
英文摘要: When performing a cardiac catheterization for a patient, a team equipped with extra-corporeal membrane oxygenation (ECMO) device must be arranged in advance to ensure that the patient can receive support from it within 20 minutes once complications occur. If the physician performs a cardiac catheterization without the prior arrangement, it is a violation of the duty of care and creates an unacceptable risk of death. It is still true, even though there are no written laws or regulations that have clear requirment for this. However, in the case of complications during cardiac catheterization, even timely use first-aid from ECMO, there are still 90% of the mortality fate. Therefore, when the death result appears, it is difficult to attribute the result to the obligation violation, which didn’t arrange any support from the ECMO team (the lack of relevance of obligations violation). In other words, although the defendant during cardiac catheterization created an unacceptable risk of death, it was still impossible to determine that the death result was caused by this risk. For that reason, the consequence attribution cannot be affirmed, so there is no case of offence of negligent manslaughter.
目  次: 壹、案件概述
一、案件事實
二、專家意見
三、判決理由
貳、判決評析
一、行為不法:違反注意義務(=製造不受容許之風險)
二、結果不法:因果與歸責
參、結語
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