醫療刑責合理化修法之歷程與論述

醫療刑責合理化修法成功，在台灣醫療法制改革實務上，是一件非常難得的進展與歷史成就。雖然修法前後仍有不同的法律見解，然而，在醫療法律研究之外，在立法學、政治學、公共事務管理、危機管理學、社群媒體論述應變、醫療政策制定、醫療改革策略、政黨協商與溝通上，都是一項非常值得研究的豐富案例。修法改革過程當中，各方各黨都有很多不同又多元的主張，在法律論述戰、媒體戰、甚至國會戰，如何溝通？如何傾聽？如何尊重包容？如何協調成功？天時地利人和，各界前輩創造正向關懷力與協調力，才能修法成功，筆者在一個月當中也連發了6篇文章，接招應戰，拋磚引玉：（1）承先啟後，《醫師蔡秀男：濫告醫護上法院？誰來救命顧醫院？》；（2）接招應戰，《改革醫刑氾濫創造醫病多贏》；（3）順勢隨緣，《法接地氣，醫如觀音，醫刑改革最後一哩路》；（4）趨吉避凶，《醫師蔡秀男：消費化」與仇醫化無助改革醫療崩壞》，（5）功德圓滿，《醫療法修法成功，請蔡總統繼續改革讓醫護安心救命！》；（6）改革啟示，《態度決定高度，賴院長與蔡總統的危機處理關鍵時刻！》，也為這波台灣醫療法制改革，留下了部份歷史見證。醫療刑責合理化改革後對未來臨床醫療的影響如何？臨床醫師要如何善用法律保護目的好好保護自己？舉證之所在，勝訴之所在，也是醫病溝通雙贏之所在，簡言之，苦心修法入法的關鍵字，不懂不行！書寫病歷的舉證重點，更不能輕忽：（1）合理臨床專業裁量；（2）醫療上必要之注意義務；（3）當時當地之醫療常規；（4）醫療水準；（5）醫療設施；（6）工作條件；（7）緊急迫切等客觀情況。政治談判與法案協商，是技術也是溝通的藝術，要怎麼傾聽與回應，才能化解危機，避免黨內衝突朝野衝突？《醫療法》第82條修法改革成功，已是典範案例！希望各黨立委朋友與醫界法界繼續理性溝通合作，共同努力上醫醫國，相關醫療改革繼續努力修法成功，營造醫療友善環境，創造醫法民三贏，讓台灣醫療法制環境更好。 The rationalization of medical criminal liability has been a very rare progress and historical achievement in the practice of medical legal reform in Taiwan. Although there are still different legal opinions before and after the amendment of the law, it is worthy of further studies in many fields of research in medical law, legislation, political science, public affairs management, crisis management, social media application, medical policy making, medical reform strategy, political negotiation. During the process of reforming the law, there are many different and pluralistic ideas. How to listen? How to respect and tolerate? How to coordinate? The author also issued six articles in a month: (1) Who is going to save the hospital? (2) To innovate the reform of medical liability to create a win-win situation; (3) The last mile of medical liability reform; (4) Consumerization could not facilitate to reform medical collapse; (5) Dear President Tsai, please keep fighting for medical reform; (6) Attitude determines the height, Dean Lai and President Tsai's crisis to deal with the critical moment! ''. The articles also present historical testimony for this wave of Taiwan's medical legal reform. What is the impact of the medical reform on criminal liability and clinical care? How do clinicians apply legal reform to protect themselves? The evidence is the key to win. How to maintain the win-win situation between doctors and patients. In short, the key points of writing medical records should not be neglected: (1) reasonable exercise of professional clinical discretion; (2) the duty of due care ; (3) the customary medical practice; (4) medical level; (5) Medical facilities; (6)Working conditions; (7) level of emergency or urgency in the locality at the time of practice in the medical field concerned. The political negotiations and legal reform is more or less based on the art of communication. How can we listen and respond to resolve the crisis and avoid conflicts? Article 82 of the Medical Law has been successfully reformed and is a wonderful model! It is hoped that all stakeholders will continue to communicate, cooperate, and work together to improve the medical environment, to create a win-win situation, and make Taiwan's medical legal environment better and better.