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    题名: 民事醫療訴訟之證明法則與實務運作
    其它题名: Evidence Law and Empirical Study in Medical Malpractice Litigation
    作者: 沈冠伶;莊錦秀
    Shen, Kuan-Ling;Chuang, Ching-Hsiu
    关键词: 民事醫療訴訟;訴訟標的及金額;舉證責任分配;舉證責任轉換 證明度;鑑定;證明妨礙;醫療專庭;說明義務;契約責任;侵權責任
    Medical Civil Procedure;Suit Target & Sum;Allocation of Burdens of Proof;Shift in the Burdens of Proof;Standard of Proof/Probabilistic;Survey;Spoliation of Evidence;Medical Court;Disclosure Obligation/Informed Consent;Contract Liability;Tort Liability
    日期: 2012-06
    上传时间: 2016-06-17 12:01:31 (UTC+8)
    摘要: 為貫徹武器平等原則，我國新修正之民事訴訟法在證據法部分新增諸多規定。證明法則應如何適用始能平衡兼顧原、被告之實體利益與程序利益，向為討論重點。本文立於法釋義學研究之基礎，對民事訴訟法修正十年來之司法實務進行實證研究，探究司法裁判上對於醫療民事訴訟事件之處理現況及新增之證據法規定是否及如何應用於醫療訴訟。 我國民事醫療訴訟事件占全部民事訴訟事件之比例低於百分之一，近來則有持續增加趨勢，但其分布有城鄉之差距。涉訟醫療行為類型愈趨廣泛，不再僅限於傳統固有的醫療行為。醫療科別中又以內科、外科及婦產科等高風險、結果不可預測性高的科別最易涉訟。聲明與勝訴項目金額與其他民事損害賠償事件差異不大，未有索賠過高的現象。就訴訟標的之法律關係多主張侵權行為損害賠償責任，但晚近醫師說明義務有無履行之爭議愈趨增加。 我國法院對舉證責任分配方式多未明白表示，但漸增轉換由被告負擔之案例，惟其認有顯失公平之理由仍不明確，難以歸納類型。有少數個案以降低證明度標準（優勢證明）之方式認定事實，證明妨礙之案例仍為少數，且少有依民事訴訟法第二二二條第二項規定認定賠償金額者。鑑定方法中以鑑定占重要地位，但鑑定證據多為囑託機關鑑定，而未能使鑑定人到庭由當事人直接詢問，對於當事人之聽審請求權保障不足，應強化醫療專庭與醫療專家間之協力，重新建構足以保障當事人之聽審請求權並促進訴訟的鑑定程序。就醫師說明義務違反之舉證責任，實務見解亦存在分歧。
    To realize the principle of equality, the newly amended Taiwan Code of Civil Procedure includes many new rules for evidence law. How the burden of proof should be applied to balance the substantial and procedural interests of both the plaintiff and the defendant has always been an issue. This article is an empirical study of judicial practice regarding the Code as amended over the past ten years. It explores how medical civil procedure is handled according to jurisdiction, and whether and how the new evidence law is applicable to these lawsuits. This article finds that in the past such lawsuits accounted for less than 1% of all civil lawsuits but the percentage has been steadily increasing recently; however, geographical distribution shows urban and rural differences. Litigious medical behavior is becoming more diversified and is no longer limited to conventional medical procedures. Internal medicine, Surgical and OB/GYN, for example, are particularly susceptible to lawsuits due to their high risks and unpredictable medical results. Their statements, suit sums and items do not vary much from other civil damages suits. There have not been extravagant claims, either. As far as suit target is concerned, most assert tort liability; however, a recent increase in disputes over whether or not informed consent is obtained has been noted. In general, Taiwan’s courts do not have a specified stance on allocation of burdens of proof, and an increasing number of cases show a shift of the burden of proof to the defendant. Nevertheless, reasons supporting a lack of fairness in this trend are unclear so categorization is difficult. Facts have been determined through reduced standard of proof (advantageous evidence) in a few cases and spoliation of evidence is rare. In addition, few damages are determined according to Article 222(2) of the Civil Procedure Law. Expert Witness plays an important role in lawsuits, but evidence is mostly surveyed by an authorized organization or institute instead of having the survey expert appear in court and questioned by the party, and this undermines the party’s right to a fair hearing. Practical opinions on the burden of proof in the case of violation of physician’s disclosure obligation remain disparate.
    關聯: 法學評論, 127,167-266頁
    Chengchi law review
    数据类型: article
    显示于类别:[政大法學評論 TSSCI] 期刊論文

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