醫事訴訟中因果關係之判定

The Determination of Causation in Medical Lawsuits

醫事訴訟案件所涉及之因果關係判斷，無非在於釐清「病患所受之傷害是否為醫療行為所造成」之命題，與其沉酖於相當因果關係理論之「相當性」，毋寧深刻體認此類案件之判斷核心乃在於「事實上之因果關係」；就此，法院常須倚賴醫事鑑定之協助。是筆者試釐清若干法界與醫界對因果關係理解與溝通上之誤會，並說明實證醫學數據之運用原則，盼能對提升醫事訴訟中因果關係判定之正確性有所助益。

The determination of causation in medical lawsuits aims to answer one question: Are patient’s damages caused by medical behaviors? Rather than obsessing with the “adequacy” of adequate causation theory, we should realize that the core of this question is “factual causation.” Thus, our courts often rely on the assistance of medical dispute case assessment. To promote proper determination of causation in medical lawsuits, the author attempts to clarify some judicial and medical practices’ misunderstandings for causation and illustrate the application of evidence-based medicine statistics.