刑事法上醫療過失之認定案例分析

Identifying Cases of Medical Negligence in Criminal Law

目的：針對曾被法院認定醫療過程有過失情形之案例進行討論及分析，藉此防止類似情形再次發生，以減少醫療糾紛。方法：分析衛生福利部受理委託醫事鑑定案件資料，並兼評三則醫療糾紛刑事案件。結果：經由衛生福利部受理之醫療糾紛案件資料顯示，近十二年醫療糾紛每年平均468件，每天發生約1.28件，不可謂不少，而這些醫療糾紛案件中，76.5%病人及家屬會以刑事案類提告，22.3%會以民事案類提告。為何刑事案類比例偏高，經瞭解刑事案類偏高原因及分析三則判決過失原因後提出意見，期望藉由建議事項讓醫療人員及醫療機構瞭解刑法上規定之醫療過失要件及類型，避免發生類似違失，以免去後續訴訟之累。結論：分析法院醫療糾紛刑事案件內容後，提出具體建議：（1）強化醫療救護標準作業流程；（2）醫療診斷行為紀錄應詳細記載病歷或其他書面資料；（3）設置專業調處單位。若此，相信能明確區別係醫療疏失或病人病情所造成之傷亡結果，減少醫療糾紛與訴訟，提高調處成功率。 Objective: To discuss and analyze cases where the court determined that medical negligence had occurred and identify key factors to prevent the occurrence of similar medical disputes. Methods: Analysis of data on medical appraisal cases accepted by the Ministry of Health and Welfare and review of three criminal medical negligence cases. Results: According to the data, an average of 468 medical negligence cases have been filed in court per year over the preceding 12 years; this averages to a high rate of 1.28 cases per day. Of these cases, 76.5% were criminal and 22.3% were civil; this is a high proportion of criminal cases. We analyzed the grounds for three medical negligence cases and arrived at conclusions concerning how to prevent such cases from occurring in the future. Conclusion: Based on our findings, the following specific recommendations are made. First, the standard for medical rescue operations should be strengthened. Second, comprehensive medical records should be included in case filings. Third, specialized mediation units should be established for medical negligence cases. In conclusion, deaths caused by malpractice can be readily distinguished from those caused by actual medical conditions, and thus mediation of malpracticebased claims could yield a high rate of success.