醫師說明義務,本文從最基本的面向開始探討,人權、憲法人性尊嚴、人格權、自主權、健康權、醫療人權可以說是這個概念的基礎,如果沒有重視這些概念,作為厚實的地基,醫師說明義務對於自主權保護結構恐怕很難堅固。
醫師說明義務從醫學倫理階段被提升成為法律階層,從我國法律繼受的淵源來看,醫師說明義務開始從民法的契約法、侵權行為法漸漸茁壯,兩者不會衝突,甚至互相交融,並透過我國法院之案例判決,來透視醫師說明義務的面貌。
此外,刑法的阻卻違法事由對於正當醫療業務行為的肯定,醫師說明義務也是當中一個重要的環節。在醫療糾紛訴訟過程中,民事訴訟上當事人請求權的主張,證據的的提出,舉證責任的轉換,以及刑事訴訟上對證據的取捨、證明的程度,都關係到當事人的訴訟權益。
由上可知,醫師說明義務影響的層面非常廣大,關係到病患的自主權、健康權甚至到生命權。常言:醫師一盎司的告知說明,勝過於法院一磅的無過失抗辯。當醫師盡到說明義務,以防止不必要的醫療糾紛發生,正是對法律風險的體認,也就是預防勝於治療的概念。
“Informed Consent”—doctor’s duty to inform—is the premise of the right of patient autonomy. Without emphasizing the importance of the duty, one cannot make a concrete discourse on the right. When the right has been the center of legal-medical discussion/debate for years, the duty has been transformed from a medical ethic issue into a legal obligation in Taiwan. Regardless of the aforementioned transformation, a thorough legal examination and discussion has not yet been made in Taiwan. This thesis intends to fill the research blank, and discuss the duty, starting from the duty’s basic concepts--human rights, human dignity, patient autonomy, and health care right, to its relevant civil, criminal, and procedural law issues. This thesis will also analyze Taiwanese court decisions to show how Taiwanese judiciary treats the informed consent issue. Lastly, this thesis will conclude with the need to introduce the idea of legal risk into the discourse of the duty in Taiwan. “An ounce of informed consent is worth a pound of malpractice defense,” as the old saying goes. This thesis argues that taking legal risk into consideration of constructing the concept of the duty can reduce unnecessary legal medical conflicts between doctors and patients.