醫法互動最前線：台灣與美國醫療機構法務部門之實證比較分析

本文以文獻回顧與訪談為研究方法，透過與台灣與美國醫療法律師、醫療法學者、以及醫療機構法務部門人員之訪談，對兩國醫療機構法務部門之角色與運作模式進行初步實證比較分析。本文發現，台灣與美國醫療機構所面臨的法律業務，至少在契約／勞資／醫糾／法遵等領域存在不少重疊之處。然而相較於美國醫療機構普遍設有法務總顧問、法令遵循與風險管理等部門，台灣醫療機構處理法律業務尚缺乏一致的制度模型，許多醫療機構甚至並未設置法務部門，而透過一般行政部門來處理相關業務。即便設有法務單位，台灣醫療機構也幾乎不會聘任律師擔任法務，而偏好聘用新進的大學畢業生，與美國以律師為核心的模式有所差異。本文認為這些現象的背後，受到我國醫療機構分類方式、醫療機構經濟規模、以及醫院領導階層對法律專業之傳統想像等因素之影響。本文進一步主張，上述我國醫療機構對於是否設置法務部門的考量因素，忽視了法律專業人員進入醫療機構相較外部律師之比較優勢，及其對醫療機構風險管理與法令遵循可能產生之潛在效益。基於這些優勢與效益，本文主張我國應推動醫療機構普遍建置法務部門，以強化醫療機構對法律事務的應對與處理。本文並呼籲我國法學教育應致力於醫療法領域之課程整合與專業養成，以深化法學教育與醫療產業實務之連結。

By conducting a literature review and interviews with health lawyers, health law scholars, and hospital personnel charged with handling legal affairs, this paper provides a preliminary comparative analysis of the role(s) and function(s) of legal departments in both Taiwan and the US. The investigation revealed that both healthcare organizations in Taiwan and the US in their daily function have to address legal issues involving contract law and disputes, labor law and disputes, medical malpractice and risk management, and legal or regulatory compliance. However, unlike US healthcare organizations typically establish the office of General Counsel, Risk Management, and Compliance Officers, healthcare organizations in Taiwan do not have standardized model for handling legal affairs, with many of which lacking legal department altogether and relying heavily on non-legally trained administrative staff to handle these workloads. Even for those with legal department and/or legally trained personnel, the situation in Taiwan and the US differs. Most healthcare organizations in Taiwan do not hire lawyers to serve as legal counsel, but rather prefer to hire newly graduated students with undergraduate law degree to hold those positions. This paper argues that such a difference is a function of local contextual factors such as the legal classifications and economic scale of healthcare organizations, as well as the leadership’s imagination of the role and value of legal services. The paper further argues that these local factors neglect the potential: 1) comparative advantage of incorporating legally trained professionals into healthcare organization over relying on outside lawyers, and 2) organizational benefits for more efficient risk management and regulatory compliance. Based on these potential advantages and benefits, this paper suggests that the Taiwanese society should encourage more hospitals to establish the legal department or office of legal counsel to strengthen their capacity to both handle common legal issues and respond to unexpected challenges. This paper also calls for more intentional and comprehensive integration of courses and professional training programs in the field of health law in Taiwan, so as to prepare more legally trained professionals ready to take the challenge of healthcare law practice.