醫療糾紛病人自力救濟之個案分析

A Case Study of Patient Self-actions in Medicolegal Issue

醫療糾紛自力救濟行為在我國層出不窮，但是如此激烈的行為卻是國際社會所罕見的，這也讓許多醫護人員心生畏懼，本研究欲以病患的觀點瞭解為何病患要採用自力救濟行為。本研究個案為一名年為七十七歲罹患大腸癌之病患，並於手術後死亡，本研究採用個案研究法以了解家屬與醫院之互動過程，以及爆發自力救濟事件的成因。本研究發現個案家屬與醫師缺乏互動，且不瞭解手術可能之風險，而在事件發生後院方又無法立即取得家屬之信任，再加上家屬本身的經濟能力不足無法採用法律訴訟以及身為長子所背負的家族壓力，引發此起抗議事件。依據研究結果，本研究認為強化醫病的互動，以同理心感受病患的需求、並且以開誠布公的處理態度提供家屬迅速而透明的資訊，唯有回歸到待人如己、視病猶親的醫療本質，營造一個以病人為中心的醫療環境方為減輕醫療糾紛所帶來的傷害甚至是消弭醫療糾紛的不二法門。

Self-actions events in medical legal have happened frequently in Taiwan. Such a strong action were rare compared with other international societies makes many medical staffs worried about this scenario, this study is from patient’s point of view to understand their self-actions behavior. The case of this study was a 77 years old male who had suffered colon cancer, and died after surgery. This study used case study method to show the interaction between physician and the relatives, and the causes of the self-actions event. The results showed that the relatives in this case were lack of interaction with the physician, and could not comprehend the risk of surgery. After the event, the hospital did not gain the family’s trust immediately. Furthermore, the relatives could not afford the litigation, and had pressure from family as for the first born child. It brought out the event. According to the results, this study considered that to improve the interaction between physician and patient, to empathy the patient’s needs, to offer rapid and complete information with sincere attitude, to treat patient as family, and to create a patient-centered environment are the best ways to reduce harm from or even decrease the medical legal issue.