醫療糾紛處理及事故補償法制之研究──以美國法制為中心

A Study of Medical Dispute and Compensation Law: Focusing on American Legal System

系所名稱：科技法律研究所 學位別：碩士 畢業學年：102年 指導教授：楊智傑 現今醫療糾紛及醫療之民刑事訴訟已成為常態，尤以提起刑事訴追並附帶民事請求損害賠償案件更是屢見不鮮，截至2011年之刑事案件已高達414件、民事案件亦高達132件，此現象除導致司法資源的鉅耗，更使得醫護人員於執業時無法受到保護，進而有防衛性醫療行為產生。有鑒於此，我國於2012年12月公布行政院版之醫療糾紛處理及醫療事故補償法草案，另推行鼓勵醫療機構辦理生育事故爭議事件試辦計畫，冀望能提升醫護人員執業環境的安全保護、病患就醫權益保障及改善醫病雙方之互動關係。惟該草案與試辦計畫中有諸多制度仍待精進，遂本研究以美國維吉尼亞州及佛羅里達州施行之「新生兒神經損傷補償法案」、全國性醫療改革之聯邦法案「醫療錯誤揭露及賠償法案」，以及新罕布什爾州採行之「早期支付賠償法案」等，並借重國外法案制度探討我國法案之各面向制度之問題與缺失，進而提出妥適合宜的法制修正或立法之方向。本研究分敘為：第一章說明研究之動機與目的、研究方法及研究之範圍；第二章則先以探討美國醫療過失之現狀，以及醫療危機爆發後，各州進行侵權行為法改革之方法；第三章遂更進一步針對美國之無過失責任與補償法制，並以維吉尼亞州及佛羅里達州之法案為研究；第四章以美國醫療錯誤揭露及賠償法案為本研究重心，即深入探討其立法與條文之重點，以及探討美國過半數州所施行之道歉法制，並研究其他解決醫療糾紛之法案；第五章係研究我國醫糾法草案與生育事故試辦計畫之立法起源與重點，並與本研究之美國各法案對照我國法制草案比較其異同；第六章，則提出個人觀點與構思想法，並認為應支持新罕布什爾州早期支付賠償法案，因為補償絕對不是唯一辦法，作成結論。

The medical dispute and civil and criminal lawsuits more often occur in themedical activity nowadays, especially that criminal litigation prosecuted with civilcompensation for damages. There were 414 criminal cases and 132 civil cases till theend of 2011, this lawsuit abuse situation waste judicial resources, weaken the protectionfor medical personnel (include nurse) and cause defensive medical decision making.Thus, in order to enhance the protection for medical personnel, ensure patientrights and interests and improve the relationship between these two parties, governmentaddressed the Executive Yuan draft of Medical Dispute and Medical MalpracticeCompensation Act in December 2012, and Presentation of Birth Injury CompensationProject. Our research focuses on three main Acts which are: the Birth-RelatedNeurological Injury Compensation Act in Virginia and Florida, the National MedicalError Disclosure and Compensation Act and the Early-Offer for Medical Injury ClaimsAct in New Hampshire. Analyze and study these Acts thoroughly which may helpcomplete Taiwan’s draft and we try to suggest properly revised opinion or the directionof amendment.The first part of this study is the description of motivation, approach, method andscope. Second part will start from the current medical dispute situation in the USA andthe way to reform torts law in states after medical crisis. Third part will aim at No-Faultliability compensation legal system and focus on the lawsuits in Virginia and Floridaespecially. Forth part will study and analyze theNational Medical Error Disclosure andCompensation Act thoroughly and investigate the Apology Law implement at severalstates in America. Fifth part will review the focal point of the draft of Medical Disputeand Medical Malpractice Compensation Act and Presentation of Birth InjuryCompensation Project in Taiwan. Sixth part will compare the USA and Taiwan’s Actsoverall. Finally, this study will raise some personal suggestion and opinion from aboveall, and in sum, we intend to support the Early-Offer for Medical Injury Claims Act inNew Hampshire, for the reason that compensation is not the only solution and the Act inNew Hampshire may fix the dilemma we face right now.