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林鈺雄「初探德國醫療糾紛鑑定調解會制度」整理
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「一起讀判決」整理自林鈺雄,「初探德國醫療糾紛鑑定調解會制度-兼論解決醫療糾紛之立法原則」,月旦法學雜誌217,2013年6月
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林鈺雄「初探德國醫療糾紛鑑定調解會制度」整理
1.
德國鑑定調解會制度 • 1975年起,設置於醫師公會,免費進⾏行,案量逐年增加 • 先鑑定、後調解,成員包括醫界與法界 •
鑑定會先提出鑑定報告,⾄至少⼀一位醫師委員背景和受申訴 醫師相同 • 調解會再就民事責任提出意⾒見 • ⾃自願性原則:醫病皆可提出聲請、但開始進⾏行需經醫病雙⽅方 同意 • 無拘束性原則:鑑調會決定不拘束法院跟醫病雙⽅方 「⼀一起讀判決」整理⾃自林鈺雄,「初探德國醫療糾紛鑑定調解會制 度-兼論解決醫療糾紛之⽴立法原則」,⽉月旦法學雜誌217,2013年6⽉月
2.
鑑調聲請佔醫糾案件四分之⼀一 • 德國⼀一年約有四億次診療 • 每年約有四萬件醫療糾紛案件,佔診療次數的萬分之⼀一 •
約⼀一萬件向鑑調會提出聲請 • 其餘三萬件,多數由醫療保險機構解決,少數病⽅方採取 司法途徑=>醫療責任保險制度扮演重要⾓角⾊色 「⼀一起讀判決」整理⾃自林鈺雄,「初探德國醫療糾紛鑑定調解會制 度-兼論解決醫療糾紛之⽴立法原則」,⽉月旦法學雜誌217,2013年6⽉月
3.
2011年德國鑑定調解會 判定有疏失約四分之⼀一 備註: 1. 2011年鑑調會共受理11,107件,做成11,033件, 其中7,452件做成實質決定。 2. 未做成實質決定係指程序上不合規定,⽐比如申請 前已經提起訴訟。69% 5% 26% 有醫療疏失(1,901件) 有醫療疏失/無因果關係(386件) 無醫療疏失(5,165件) 「⼀一起讀判決」整理⾃自林鈺雄,「初探德國醫療糾紛鑑定調解會制 度-兼論解決醫療糾紛之⽴立法原則」,⽉月旦法學雜誌217,2013年6⽉月
4.
判定有疏失案件 3%⾛走⼊入法院 • 86%病⽅方直接由保險獲得 給付 • 11%判定醫⽅方有疏失,但 病患卻不要賠償 •
3%⾛走⼊入法院 11% 3% 86% 保險給付 法院途徑 無後續⾏行動 「⼀一起讀判決」整理⾃自林鈺雄,「初探德國醫療糾紛鑑定調解會制 度-兼論解決醫療糾紛之⽴立法原則」,⽉月旦法學雜誌217,2013年6⽉月
5.
2011年鑑定調解會 受理案件之診療地點 其他(如診所) 28% 醫院 72% • 醫院醫師6,130⼈人次 • 其他(如診所)醫師2,363 ⼈人次 •
鑑調會每件聲請⾄至多申訴 4名醫師 「⼀一起讀判決」整理⾃自林鈺雄,「初探德國醫療糾紛鑑定調解會制 度-兼論解決醫療糾紛之⽴立法原則」,⽉月旦法學雜誌217,2013年6⽉月
6.
2011年鑑調會 受理醫師之科別統計 醫院 ⼈人數 ⽐比例 創傷外科/⾻骨科 1977
32.3% ⼀一般外科 1003 16.4% 內科 461 7.5% 婦科 394 6.4% 神經外科 252 4.1% ⿇麻醉科、加護科 234 3.8% 泌尿科 213 3.5% 助產科 196 3.2% 神經科 146 2.4% ⽿耳鼻喉科 144 2.3% 其他 1110 18.1% 其他(如診所) ⼈人數 ⽐比例 創傷外科/⾻骨科 573 21.8% 家醫科 320 12.2% ⼀一般外科 243 9.3% 內科 201 7.7% 婦科 152 5.8% 眼科 150 5.7% 放射科 129 4.9% 泌尿科 99 3.8% ⽪皮膚、性病科 92 3.5% ⽿耳鼻喉科 80 3.0% 其他 597 22.7%