德日遠距醫療的規範與實踐：兼論對我國之借鑑

Laws and the Practice of Telemedicine in Germany and Japan: Insights and References for Taiwan

隨著科技的發展，人工智慧的技術日漸成熟，遠距醫療成為當下的熱門話題，所謂的遠距醫療，是指醫護人員實現健康照護時，受到距離影響，以通訊科技達到治療、預防疾病和傷害、研究、評估，甚至衛生人員繼續教育的目的，實現個人與社區健康利益。
2020年開始，新冠肺炎肆虐全球，因應疫情，各國都在積極放寬遠距醫療的法令並進行多元的嘗試，我國自2018年頒布《通訊診察治療辦法》後，便開始實行有限度的遠距醫療，2022年衛生福利部更公告修正草案，針對遠距醫療的適用對象及內容放寬，但相較之下，放寬遠距醫療的幅度，猶嫌不足。
為了跟上國際醫療模式發展的步伐，應該研析先進國家的醫療策略與法制，我國法律制度源於歐陸體系，深受德國與日本法制的影響，本文主要從具有醫師「診療與開立處方箋等的核心醫療行為」的遠距醫療角度出發，介紹德國、日本兩國實施遠距醫療的規範與實踐，進行兩國相關規範的重點比較，並分析可為我國借鑑之處，特別是關於遠距醫療的運用範圍與要件、醫師應尊重病人自主同意與告知義務之內容、以及資訊安全之監督等，皆值得提供我國法律政策調整的參考。

With the development of science and technology, the artificial intelligence is getting more and more mature, and telemedicine has become a hot topic these days. Telemedicine refers to the use of communication technology for the purpose of treatment, prevention of diseases and injuries, research, assessment, or even continuing education of healthcare workers to achieve individual and community health benefits when the practices of healthcare providers are affected by distance.
The COVID-19 pandemic hits the world in 2020, and countries are actively relaxing their laws and regulations of telemedicine and making various efforts in response to the pandemic. In Taiwan, telemedicine has been implemented in a limited manner since the enactment of“Rules of Medical Diagnosis and Treatment by Telecommunications”in 2018, and a draft amendment which relaxes the requirements of applicable objects and the content of telemedicine has been announced by the Ministry of Health and Welfare in 2022. However, the relaxation of the use of telemedicine in our country is still not enough to date by comparison.
To keep up pace with the development of the international medical model, it is necessary to study the medical policies and legal systems of those advanced countries. Our legal system is derived from the European system, and it is strongly influenced by the legal systems of Germany and Japan. This article introduces norms and the practice in Germany and Japan from the perspective of telemedicine, where doctors perform core medical practices such as diagnosis, treatments, and prescriptions. In addition, this article compares laws and regulations relating to the implementation of telemedicine between two countries and analyzes the points that we can learn from. In particular, the scope and requirements of telemedicine, the content of patients’right to autonomy, doctors’obligation to inform, and the supervision of the data security, etc. are worthy of reference when adjusting our own legal policies.