| 研究生: |
李威廷 Li, Wei-Ting |
|---|---|
| 論文名稱: |
由愛滋器官移植事件看我國的醫療損害填補法制 The Legal System of Medical Damage Compensation:Based on HIV-infected Organ Transplantation Event |
| 指導教授: |
許登科
Hsu, Teng-Ko |
| 學位類別: |
碩士 Master |
| 系所名稱: |
社會科學院 - 法律學系 Department of Law |
| 論文出版年: | 2015 |
| 畢業學年度: | 103 |
| 語文別: | 中文 |
| 論文頁數: | 166 |
| 中文關鍵詞: | 愛滋器官移植事件 、損害填補 、國家賠償法 、病人賠償保險制度 、無過失補償制度 、醫療糾紛處理及醫療事故補償法 |
| 外文關鍵詞: | HIV-infected Organ Transplantation Event, Damage Compensation, State Compensation Law, Patient Compensation Insurance, Accident Compensation Scheme, Medical Disputes and Medical Incident Compensation Law |
| 相關次數: | 點閱:126 下載:5 |
| 分享至: |
| 查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報 |
損害填補理論不單是民法的重要課題,也是國家賠償法的基礎。訴訟的過程與標的物雖因案而異,最主要的癥結仍是因果關係的連結與故意過失的認定。數年前轟動一時的愛滋器官移植事件,事後發現是連繫上的失誤所造成。該事件同時挑戰了醫療與法律制度的缺失。在醫療部分,全台灣最頂尖的器官移植團隊在手術流程中發生重大缺失,改革並建立完整手術流程刻不容緩;在法律部分,五位器官移植手術受害者的民刑事究責對象與過程隱晦未明,至今仍無具體結論。衛生署的報告與監察院的調查雖引起公立醫院醫師是否具有公務員資格的爭辯,然基於醫療非公權力之範疇,國家賠償的議題輕描淡寫帶過。
國家基於對危險社會的防範,以及對醫療人權的保障,應透過行政管制的手段維護人民的健康權避免侵犯,尤其是在尖端醫療科技下進行器官移植的患者。財團法人器官捐贈移植登錄中心在法規的授權下成立,成員乃具有公務員的身分。除了依其擁有之職權行事,也應擔負職務上的義務與責任,徹底落實政府對器官移植醫學的行政管制政策,避免下一次憾事的發生。政府面對未來醫療糾紛有增無減,實務上除了仰賴醫療鑑定,也應充分發揮和解與調解的功能;制度上參考瑞典的「病人賠償保險制度」與紐西蘭的「無過失補償制度」,試圖建立本土的醫療糾紛處理法。基於醫療的複雜性與國情的差異,以及醫界法界之間的不同認知,儘管仍有多方歧見等待整合,最後目標仍然是建立完整且公平的醫療損害填補制度。
The theory of damage compensation is not only an important task in civil laws, but also the basis of State Compensation Law. The crucial issue is the determination of casual connection and willful negligence. The famous organ transplants from an HIV-infected donor case years ago, was found as misinterpret the answer of “reactive” as “negative” (non-reactive) over the phone. The specific incident has challenged the deficiency of both the medical and legal system. As to the medicine, a major flaw occurred in the surgical procedure of the top organ transplant team in Taiwan, a reformation and a complete surgical procedure shall be admitted immediately; as to the law, the liable party and process of civil and criminal offenses to the five victims of the surgery is still obscure and without definite conclusion. Although the investigation of the Ministry of Health and Welfare and the Control Yuan has triggered a debate on whether physicians of public hospitals are qualified as public servants, issues of state compensation have just been mentioned lightly for medicine shall be out of the scope of public power.
Based on a precaution to social risks and a protection to human rights in health care, health rights of people shall be protected by administrative regulation, especially patients in high medical technology organ transplants. Taiwan Organ Registry and Sharing Center is established under the authorization of the law, and its members are qualified as public servants. They shall be obliged and liable to their jobs besides their authorities. A complete practice of administrative control policy from the government in organ transplants may prevent a regrettable incident in the future. Facing the increasing of medical disputes, our government shall not only depend on medical examinations, but also fully apply its functions in settlement and mediation. The “Patient Compensation Insurance” in Sweden and “No-fault Compensation” in New Zealand may be references as building a Medical Disputes and Medical Incident Compensation Law in Taiwan. The complexity of medical system and the variety of different countries, as well as the cognitive dissonance from faculties of medicine and law may be required to be integrated, and the target is to establish a complete and fair medical compensation system.
壹、專書著作
1. Munroe Smith,歐陸法律發展史。姚梅鎮譯,2006年,台灣商務印書館發行。
2. 王水深,朱樹勳,李源德主編,台大醫院心臟移植團隊著,心臟移植,2011年12月初版。
3. 王澤鑑,侵權行為法(一):基本理論,一般侵權行為,三民書局,2005年1月初版十刷。
4. 江建勳,愛滋病肆虐三十載,台灣商務印書館,2012年5月。
5. 行政院衛生署疾病管制局編,愛滋病防治工作手冊,2009年12月。
6. 行政院衛生署與省政府衛生處合編,愛滋病全貌1992,民國81年5月。
7. 吳庚,行政法之理論與實用,三民書局,2008年9月增訂十版。
8. 李伯璋,一步一腳印,國立成功大學出版,2006年2月二版。
9. 李建良,基本權利與國家保護義務。憲法理論與實踐,學林出版社,2000年。
10. 柯順隆,向愛滋病挑戰,國家出版社,民國77年6月。
11. 財團法人器官捐贈移植登錄中心編,轉念,大愛,讓生命延續。合計圖書出版社,2010年12月初版。
12. 國立台灣大學醫學院附設醫院愛滋病防治中心編,愛滋病學。健康文化出版,2006年8月二版。
13. 張特生,國家賠償法研習資料彙編,法務部印行,1981年9月。
14. 曹競輝,國家賠償法實用,五南圖書,1984年12月初版修訂。
15. 望月禮二郎,英美法。郭建譯,五南圖書,1999年初版。
16. 葉百修,國家賠償法之理論與實務,元照出版社,2011年3月三版。
17. 廖義男,國家賠償法,三民書局,1993年7月增訂初版。
18. 劉春堂,國家賠償法,三民書局,1982年2月。
19. 戴炎輝,中國法制史,三民書局,民國55年初版。
20. 鍾文榮,國家賠償法之研究,興業圖書初版,1982年2月。
貳、國內期刊
1. 王澤鑑,危險社會、保護國家與損害賠償法。月旦法學雜誌,第117期,2005年2月。
2. 吳全峰,黃文宏。從醫療人權之角度論全民健康保險強制納保制度之爭議,月旦法學雜誌,77期,2001年9月。
3. 吳全峰,黃文宏。論醫療人權之發展與權利體系,月旦法學雜誌,148期,2007年8月。
4. 吳秀瑾,Cindy Patton討論與愛滋病相關的法律與醫療倫理問題。應用倫理研究通訊,第一期,民國86年10月。
5. 吳俊穎、賴惠蓁、陳榮基,台灣的醫療糾紛現況,台灣醫學,13卷1期,2009年1月。
6. 侯英泠,探討醫療無過失責任的適宜性,月旦法學雜誌,49期,1999年6月。
7. 高添富,林建智,醫事人員強制責任保險制度之研究。政大法學評論,110期,1999年8月。
8. 張孟源 盧言珮,臺灣器官移植制度困境與展望--從愛滋器捐事件談起。台灣醫界,54期,2011年11月。
9. 陳學德,醫療風險與糾紛解決之道--從台灣台中地方法院試辦醫療制度談起,月旦法學雜誌,223期,2013年12月。
10. 楊秀儀,瑞典「病人賠償保險」制度之研究—對台灣醫療傷害責任制之啟發。台大法學論叢,第三十期,民國90年11月。
參、國外期刊
1. Allan Concejero, Chen CL, Wang CC, et al. Living Donor Liver Transplantation for Hepatocellular Carcinoma: A Single-Center Experience in Taiwan. Transplantation. 2008;85:398–406.
2. Bellandi, et al. Unintended transplantation of three organs from an HIV-positive donor: report of the analysis of an adverse event in a regional health care service in Italy. Transplant Proc. 2007;42(6):2187-9.
3. Brennan TA, Leape LL, Laird NM, et al.: Incidence of adverse events and negligence in hospitalised patients. Results of the Harvard medical practice study I. N Engl J Med. 1991;324:370–376.
4. Centers for Disease Control and Prevention. Guidelines for Preventing Opportunistic Infections Among HIV-Infected Persons. MMWR. 2002;51(RR8):1-46.
5. Centers for Disease Control and Prevention. Treating Opportunistic Infections Among HIV-Infected Adults and Adolescents. MMWR. 2004;53(RR14):1-63.
6. Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365:493- 505.
7. Daniel Kreisel, Alexander S. Krupnick, Varun Puri, et al. Short- and long-term outcomes of 1000 adult lung transplant recipients at a single center. J Thorac Cardiovasc Surg. 2011;141:215-22.
8. Daniel Marelli, Hillel Laks, Jon A Kobashigawa, et al. Seventeen-Year Experience With 1,083 Heart Transplants at a Single Institution. Ann Thorac Surg 2002;74:1558–67.
9. David D. Ho, Time to Hit HIV, Early and Hard. N Engl J Med. 1995; 333:450-451.
10. F Barre-Sinoussi, JC Chermann, F Rey, et al. Isolation of a T-lymphotropic retrovirus from a patient at risk for acquired immune deficiency syndrome (AIDS). Science.1983;220(4599):868-71.
11. Henry Johansson. The Swedish system for compensation of patient injuries. Upsala Journal of Medical Sciences. 2010;115:88-90.
12. Hsu HY, Chang MH, Chen DS, et al. Baseline seroepidemiology of hepatitis B virus infection in children in Taipei, 1984: A study just before mass hepatitis B vaccination program in Taiwan. J. Med. Virol. 18:301-307, 1986.
13. Hung CC, Hsiao CF, Chen MY, et al. Improved Survival of Persons with Human Immunodeficiency Virus Type 1 Infection in the Era of Highly Active Antiretroviral Therapy in Taiwan. J Infect Dis. 2006;59:222-228.
14. Hymes, K.B., Greene, J. B., Marcus, A., et al. Kaposi’s sarcoma in Homosexual men—A report or eight cases. Lancet.1981;2(8247):598-600.
15. Kachalia Allen, Mello MM. New direction in Medical Liability Reform. N Engl J Med. 2011;364:1564-72.
16. Lee YC, Chang YL, Chen JS, et al. Lung Transplantation—The Surgical Experience. Transplantation Proceedings, 35, 445–446 (2003).
17. Liu PP, Chen CL, Chen YS, et al. Experience with liver transplantation in Taiwan. Transplantation Proceedings. 1998;30:3178-3179.
18. Lucey MR, Merion RM, Henley KS, et al. Selection for and outcome of liver transplantation in alcoholic liver disease. Gastroenterology. 1992, 102(5):1736-1741.
19. Mangalmurti SS, Murtagh L, Mello MM. Medical Malpractice Liability in the Age of Electronic Health Records. N Engl J Med. 2010;363:2060-67.
20. Mello MM, Studdert DM, Kachakia, Allen. The Medical Liability Climate and Prospects for Reform. JAMA. 2014;312(20):2146-2155.
21. Ormaasen V. Sandvik L. Dudman SG. Bruun JN. HIV related and non-HIV related mortality before and after the introduction of highly active antiretroviral therapy (HAART) in Norway compared to the general population. Scandinavian Journal of Infectious Diseases. 2007;39(1):51-7.
22. Palella FJ Jr, Delaney KM, Moorman AC, et al. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. N Engl J Med. 1998;338:853-60.
23. Pitisuttithum P, Gilbert P, Gurwith M, et al. Randomized, double-blind, placebo controlled efficacy trial of a bivalent recombinant glycoprotein 120 HIV-1 vaccine among injection drug users in Bangkok, Thailand. J Infect Dis. 2006;194:1661-71.
24. Rerks-Ngarm S, Pitisuttithum P, Nitayaphan S, et al. Vaccination with ALVAC and AIDSVAX to prevent HIV-1 infection in Thailand. N Engl J Med. 2009;361:2209-20.
25. Robert Pfitzmann, Jeannette Schwenzer, Nada Rayes, et al. Long-term Survival and Predictors of Relapse After Orthotopic Liver Transplantation for Alcoholic Liver Disease. Liver Transplantation. 2007;13:197-205.
26. Ronald E. Cranford. Uniform Brain Death Act. Neurology. 1979;29(3):417-8.
27. Schwartlander B, Stover J, Hallett T, et al. Towards an improved investment approach for an effective response to HIV/AIDS. Lancet. 2011;377:2031-41.
28. Studdert DM, Mello MM, Gawande AA, et al.: Claims, errors, and compensation payments in medical malpractice litigation. N Engl J Med. 2006;354:2024–2033.
29. Sun CA, Chen HC, Lu CF, et al. Transmission of Hepatitis C Virus in Taiwan: Prevalence and Risk Factors Based on a Nationwide Survey. J Med Virol. 1999;59:290-296.
30. Thompson WW, Price C, Goodson B, et al. Early thimerosal exposure and neuropsychological outcomes at 7 to 10 years. N Engl J Med. 2007; 357: 1281-1292.
31. Tozzi AE, Bisiacchi P, Tarantino V, et al. Neuropsychological performance 10 years after immunization in infancy with thimerosal-containing vaccines. Pediatrics. 2009;123(2):475-82.
32. Volberding PA, Lagakos SW, Grimes JM, et al. The duration of zidovudine benefit in persons with asymptomatic HIV infection: prolonged evaluation of protocol 019 of the AIDS Clinical Trials Group. JAMA. 1994;272:437-442.
33. Webster AC, Woodroffe RC, Taylor RS, et al. Tacrolimus versus ciclosporin as primary immunosuppression for kidney transplant recipients: meta-analysis and meta-regression of randomised trial data. BMJ. 2005;331(7520):810.
34. Wei J, Chang CY, Chuang YC, et al. Heart Transplantation at Cheng Hsin General Hospital in Taiwan: 15-Year Experience. Transplantation Proceedings, 2004; 36, 2374–2376.
肆、學位論文
陳政惠,台南監所男性靜脈注射藥癮者感染愛滋病毒之危險因素探討,國立成功大學醫學院公共衛生研究所碩士論文,2006年。
伍、網頁資料
1. 財團法人器官捐贈移植登錄中心 http://www.torsc.org.tw/ 。
2. 諾貝爾獎 http://www.nobelprize.org 。
3. 日本臓器移植ネットワーク(Japan Organ Transplant NetWork,JOTNW)http://www.jotnw.or.jp/index.html 。
4. OPTN http://optn.transplant.hrsa.gov/ 。
5. 行政院衛生福利部疾病管制署 http://www.cdc.gov.tw/ 。
6. 全國藥物不良反應通報系統網址:https://adr.fda.gov.tw/Manager/WebLogin.aspx 。
7. 財團法人藥害救濟基金會http://www.tdrf.org.tw/ch/00_home/home.asp 。
8. WHO Collaborating Centre for International Drug Monitoring, Uppsala Monitoring Centre http://www.who-umc.org/ 。
9. 紐西蘭意外補償委員會(ACC) http://www.acc.co.nz/ 。
10. 瑞典病人賠償保險制度 http://www.patientforsakring.se/ 。
六、其他
1. 李建良,醫療人權的憲法基礎與保障體系,行政院國家科學委員會專題研究計畫研究成果報告(計畫編號:NSC 97-2410-H-001-048-MY3),中華民國100年12月22日。
2. 立法院公報第七十五卷第八十三期院會紀錄。
3. 立法院議案關係文書,院總第二四九號、一六零四號。