論醫師之說明義務──兼論病患之醫療人權

Issues on Physician's Informing Duty Along with Patients' Human Rights in Medical Treatment

醫師說明義務係指醫師為醫療行為前，必須將病患之病狀、治療方式、醫療行為後遺症等重要醫療訊息對病患作說明，希望病患於獲得充分且正確的醫療資訊下，可以審慎自主的做出醫療決定。我國醫療法第63條、第64條、第81條及醫師法第12條之1規定，均加諸醫療機構及醫師對於病患的告知說明義務。本文以學說、實務觀點對醫師說明義務之主體、內容、方式等進行探討，以尋找兩者間的平衡點。
本文首先對於醫師說明義務之主體加以分析，由其是醫療機構、醫師、護理人員、非醫師之醫療輔助人員等。其次針對醫師說明義務之對象，分析了主要對象如病患之法定代理人、病患之配偶及其親屬、關係人等。接著則是研究醫師說明義務之內容與方式，提出三方面的內容，如說明之內容、說明之方式及說明義務之裁量權等。最後，則分析醫師說明義務與病患代理人決定權間衝突之調和，並說明民國98年制定了國際人權兩公約施行法，以國內法的法律地位，推動醫療人權，維護人格尊嚴，改善醫病關係；經由醫療相關法制的修訂，將其病患自主權予以實現，讓病患及其家屬，甚至關係人都能獲得正確的醫療資訊。

A physician's informing duty means one physician needs to give a detail information of patient’s condition, methods of therapeutic treatment, post-therapeutic side effect, and other medical information prior to any medical treatment to patients. Hopefully, this can let patients able to make a careful decision before treatment after a complete and correct disclosure on that medical information. The content of domestic Medical Care Act on Article 63, Article 64, Article 81 and content of Physician’s Act on Article 12-1, have imposed the informing duty on both physicians and medical center. This essay aims at striking balance between patients and physicians by discussing the informed object, informed content, and informed method via theories and pragmatic viewpoints
Firstly, this essay will analyze the subject’s duty of medical side, especially the medical center, physicians, nursing personnel, and non-physicians’ medical assistance. Secondly, is on the object that needs to be informed, such as legal guardian, spouse, kinship, and any interested person of patients, etc. After that, I’ll keep discussing the methods and contents on physicians’ informing duty from 3 aspects (such as informed content, informed method and informed discretion). Finally, is to analyze how the physicians’ informing duty and patients’ legal guardian shall be coordinated when their opinion goes conflict. This essay will also explain our domestic law in response to the 2 international covenants on human rights enforcement act about how we practice and improve the patients’ dignity, patients’ human rights, as well as relations between physicians and patients; through the amendment of the related medical care act, patients can get their own autonomy when treated. Not only patients, their kinship, but also their interested persons can even be fully informed of accurate medical information under this disclosure.