醫療事故損害賠償之規範目的及法律原則

Legislative Purposes and Legal Principles of Compensation in Medical Malpractice

鑑於近年來依循司法救濟途徑請求民事賠償，漸已成為解決醫療糾紛的主要方式之ㄧ，本文嘗試整理相關學說理論，並配合實際訴訟案例，參酌法院判決所附理由，針對醫療事故損害賠償之規範目的及法律原則，逐一進行分析說明，據以評述如何在民事損害賠償訴訟上，建構起醫療事故責任範圍之衡量標準。關於醫療事故賠償範圍之量定，實務上採差額說，以被害人總財產上之差額算定損害，其範圍包括所受損害及所失利益，操作上應以該過失醫療行為對原本即處於疾病狀態之患者，究竟增加多少傷害或者死亡的風險而定。再者，不論進入責任成立或賠償範圍之檢驗階段，均應依相當因果關係之存否，對損害結果加以嚴格評價，以謀求醫療糾紛雙方當事人間之公平。

The case numbers of civil trials of medical malpractice dramatically increase in the past years in Taiwan. To construct the standards of liability and compensation in medical malpractice, we examined legal theories, courts’ decisions and legal reasoning, and legislative purposes in the present study. Currently, the “differentiated amount theory” is the most popular theory in Taiwan, which emphasizes the principle to compensate all damages and lost benefits by the incremental risk caused by liable medical practice. However, the amount of compensation should be based on the ill status of the patients before the medical practice instead of based on a healthy status. In addition, the uncertainty of medical practice, the versatility of human being, and the nature course of diseases should all be taken into account in determining causality and calculating amount of compensation in order to establish a fair compensation system for medical malpractice.