論醫療行為與消費者保護法之關係──以「美容醫學」為中心

Medical Practices and the Consumer Protection Act: The Case of Cosmetic Surgery

自消保法制定以來，醫療行為得否適用消保法第7條之無過失責任，無論於我國實務或學說上，均有豐富之討論。多數見解認為本於醫療行為具有公益性、強制性，倘課予過重之責任，將使醫師無法勇於為病患積極之治療，且醫師可能為降低風險，實施不必要之檢查，不僅可能害及病患健康，亦將增加醫療財政之負擔。此等消極及積極防衛性醫療之現象，均與消保法之立法目的有違，故不應適用無過失責任。嗣後，經立法者通過醫療法第82條後，確立以過失責任為醫療行為之歸責原理，並排除其於消保法第7條之適用範圍外。
隨著醫學不斷進步發展、經濟逐步繁榮及國民消費意識之轉變，近年美容醫學在我國快速興起，並成為一不可逆的趨勢。美容醫療行為與傳統以診療為目的之醫療行為，存在本質上之不同。申言之，美容醫療行為乃針對健康、無疾病之患者所進行，本質上係為滿足病患主觀上之好惡，而欠缺實施之必要性及急迫性。然而，我國多數文獻討論醫療行為之歸責原理時，多係以具診療目的之醫療行為，作為探討的對象。此是否得以直接移植、並適用於美容醫療行為，即有可議。
本文認為醫療法第82條之適用範圍，應僅限於具有診療為目的之狹義醫療行為，其射程不及於美容醫學等廣義醫療行為。再者，美容醫療行為欠缺公益性，不僅立法政策上欠缺特別規範之必要，其自費、高度商業化之性質，使其與一般商品、服務無異，而應有消保法第7條無過失責任之適用。

Since the enactment of the Consumer Protection Act (CPA), there has been extensive discussion in both academic and practical contexts regarding whether medical practices should be subject to the no-fault liability stipulated in Article 7 of the CPA. The majority opinion suggests that, given the public interest and obligatory nature of medical practices, imposing excessive liability could deter physicians from taking proactive measures in patient care. This could also lead physicians to conduct unnecessary tests to reduce risk, which not only would harm the patient’s health, but also increases the financial burden of medical costs. Such defensive medical practices, whether passive or active, runs counter to the legislative intent of the CPA, and therefore, no-fault liability should not apply. Following the enactment of Article 82 of the Medical Care Act, legislators established fault-based liability as the principle for medical practices, explicitly excluding their application under Article 7 of the CPA.
With the continuous advancement of medicine, economic growth, and shifting consumer consciousness, cosmetic medicine has rapidly risen in recent years in Taiwan. Cosmetic medical practices differ fundamentally from traditional medical practices aimed at diagnosis and treatment. Specifically, cosmetic procedures are performed on healthy individuals, primarily to satisfy subjective preferences, lacking both necessity and urgency. Most literature discussing the principles of liability for medical practices focuses on those with diagnostic purposes. However, whether this reasoning can be directly applied to cosmetic medical practices remains debatable.
This paper argues that the scope of Article 82 of the Medical Care Act should be limited to narrowly defined medical practices aimed at diagnosis and treatment, excluding broader medical practices such as cosmetic medicine. Furthermore, cosmetic medical practices lack a public interest component, and its self-financed, highly commercialized nature aligns it more closely with general goods and services, warranting the application of the CPA’s no-fault liability under Article 7.