國家無過失補償責任──以藥害救濟為例

The Feasibility Research of the Health Sacrifice System: Focusing on Vaccine Injury Compensation and Drug Injury Compensation

以追求國民福祉為發展目的之現代國家，一方面仍應符合法治國依法行政特色，另方面應滿足國民對幸福生活之期待。為了國家共同體之可持續發展，國家任務領域逐漸擴大，始於環境（保）問題、核能、反恐，乃至2019年肆虐並蔓延至今之嚴重特殊傳染性肺炎（COVID-19），勢將對現有之國家責任形成衝擊。如何使國家責任法制更具現代人權保障之意義，符合當代之醫療科技水準，為國家責任之演進與思維轉換下必然要思考之課題。本文藉由預防接種受害與藥害救濟之制度介紹、學理耙梳，兼及對釋字第767號解釋之檢討與借助比較法上經驗，認為因用藥所產生之風險，於用藥人正當使用合法藥物卻發生藥害結果時，也構成特別犧牲，於此情形下，與預防接種救濟並無本質上之區別。本文更進一步認為，於藥物使用致與損害結果有相當之因果關係時，亦應由國家建立補償機制予以填補，而提出「健康犧牲或健康被害制度」之概念，如能重新思考危險責任制度於我國國家責任體系內之功能，當有助於彌平風險社會中，國家於侵害人民權益之救濟類型下，有所不足之缺憾。

Though the background leading to the establishment of vaccine injury and drug injury compensation systems, the purpose to compensate for the misfortunate victims have been the same. Once acclaimed as advanced compensation systems, these two compensation systems were not proceeded without criticism. As a growing concern, governmental licensing is without doubt the most important step to guarantee vaccine and drug safety. However, in modern risk society, to pursue absolute safety is not only impossible but also a fallacy. The safety issue concerning vaccine and drug must be well balanced with need. Nowadays when right to health being regarded as a basic right and constitutional right, traditional administrative bureaucratic are facing dilemmas. Falling to provide the timely needed vaccine and drug for the public, as well as falling to serve as safety gate keeper might all constitute state compensation liability. This study summarizes the aforementioned observations to propose a conclusion and suggestions–build new one health sacrifice system.