專科護理師執業範圍與說明義務範圍界限之探討

On the Scope of Practices and Informed Consent for Nurse Practitioners

在現今的醫療現場中，護理師是醫師執行醫療業務中不可或缺的幫手，然而隨著醫療行為的複雜化，有許多業務不一定需由醫師為之，但又不適合由一般護理師執行，鑑於此，許多國家於是發展出專科護理師的制度以彌補醫師人力的不足。然而，雖然我國專科護理師制度之相關法規已逐步完善，但其執業範圍迄今仍有許多的模糊空間。為凸顯此一問題，本文首先討論專科護理師之在我國的制度源起，進而介紹專科護理師執業範圍之歷年修法沿革，及其目前依然存在之模糊地帶。最後，本文將聚焦專科護理師說明義務之部分，探討專科護理師本身得否作為說明義務之說明主體，醫師得否將說明義務轉交專科護理師為之，以及若答案為肯定，專科護理師在哪些條件上能協助分擔說明義務，而我國專科護理師執業範圍之相關法規又有何可改善之處。

Nowadays, nurses are indispensable assistants for physicians in performing medical services. However, with medical practices becoming increasingly more complex, there are growing number of medical practices that do not necessarily need to be practiced by physicians but are not suitable for general nurses either. To better handle these practices, many countries have developed the system of nurse practitioners (NPs) as a remedy to the issue of physician shortage. However, despite undeniable improvement, the current laws and regulations in Taiwan that outline NPs’ legal scope of practice remain incomplete and ambiguous.To expose this issue, the article first examines the historical origins of NPs in Taiwan, followed by an introduction to the evolution of laws and regulations regarding NPs’ legal scope of practice, and in doing so pointing out the ambiguous and grey area in the current system. Finally, the article explores the issue of informed consent for the NPs. In particular,could NPs be the ones that carry out the informed consent process? In what situations could physicians delegate the duty of acquiring informed consent to NPs? The article ends with some suggestions for improving laws and regulations on NPs’ scope of practice.