民事醫療因果關係之探討

A Study on Civil Medical Causation

醫療臨床上所面臨之醫療糾紛問題，其中，判斷困難點之一，即為因果關係之判斷。依據台灣學界通說及司法實務見解，在因果關係不明、被害人特殊體質或基因科技造成之舉證困難等情形，若堅持採相當因果關係說，將對當事人造成不公平之現象。本文透過民事醫療因果關係不同學說、外國立法例及司法實務見解之探討，介紹醫療侵權事件中，除相當因果關係外，尚有比例因果關係、疫學因果關係、市場佔有率責任理論、無過失責任及蛋殼頭蓋骨理論等外國立法例及外國法院裁判，供司法實務處理醫療糾紛時，可做為民法第1條「法理」依據之參考。

The medical dispute in medical clinic, one of the judge difficult points is causality judgment. According to the recognized law theory and judicial practice insights, In the causation is unclear, the victim has special physique, or proof difficulty caused by gene technology, if we persist causal relationship, it would be unfair to the party. This paper will discuss the different theories, foreign legislation and judicial practice insights of civil medical causation. In addition to considerable causal relationship, there are foreign legislation and referee, such as proportional causality, epidemiology causation, market share liability, no-fault liability, egg-shell skull rule in medical violations. The judicial practice can consider those, as a basis for source of law by Civil Law §1 “jurisprudence”, to handle medical disputes.