醫療暴力的反思－－建構蒐證流程標準化

Reflections on Medical Violence: Standardizing the Evidence Collection Process

醫院為治療及照顧病人之場所，然而近年醫療暴力事件報導頻繁，造成醫病關係緊張。依高雄市某醫學中心統計2020至2023年通報暴力處理事件共780件，實際於醫療業務執行之傷害共9件，其中語言暴力5件(56%)、肢體傷害4件(44%)；醫療暴力立案依規須通報衛生局與地方法院，而無法成立之原因主要係蒐證資料不完整、不知如何蒐證等，以致無法提供犯罪行為。針對恐嚇或肢體傷害案件，其蒐證資料含訪談重點摘錄、暴力事件通報表、人事物證表等，並由衛生主管機關確認後，依醫療法第24條第2項開罰。為確保受害人權利，本專題以5件成功之經驗案例，建立完善標準蒐證流程與表單，強化暴力事件蒐證能力與資料完整性，共創優質醫療環境，可供同儕醫院參考。

Hospitals are institutions designed to treat and care for patients. However, in recent years frequent reports of violence in medical facilities have strained the relationship between doctors and patients. According to statistics from a medical center in Kaohsiung City, a total of 780 violent incidents were reported between 2020 and 2023, among which were a total of 9 injuries incurred during the execution of medical services, including 5 cases of verbal violence (56%) and 4 cases of physical injury (44%). For cases of intimidation or physical injury, the collected evidence includes key excerpts of interviews, violent incident notification forms, and personnel evidence forms. Subsequent to confirmation by the appropriate health authorities, fines will be issued in accordance with Article 24, Item 2 of the Medical Law. This article reports on 5 successful cases which can help to establish and improve the standard evidence collection process and related forms. The objective is to strengthen current evidence collection protocol and the integrity of data associated with violent incidents, which can be used as a reference for peer hospitals.