告知義務與手術同意書—向英國借鏡自主原則的實踐【本期企劃】 試閱
The Duty of Disclosure and Surgical Consent Forms: Lessons from UK Case Law on Implementing Patient Autonomy
本文以病人自主原則為核心，檢視告知義務在手術同意書中的實踐與其局限。臺灣自2017年衛生福利部更新手術同意書範本以及最高法院94年度台上字第2676號刑事判決後，告知義務範圍已由「理性醫師標準」轉向「理性病人標準」。然而，同意書常因訴訟防禦而日益冗長，形成資訊悖論矛盾，未必能真正促進理解。本文以英國判例演進為借鏡，說明如何將重點置於對話與共享決策，最後並提出強化溝通教育、導入共享決策及信任導向文化等改革方向。
Grounded in the principle of patient autonomy, this article examines how the duty of disclosure is implemented through surgical consent forms in Taiwan and highlights its limitations. Following the Ministry of Health and Welfare’s 2017 revision of the standard surgical consent form and the Supreme Court Criminal Judgment No. 2676 (2005), the scope of disclosure has shifted in practice from a “reasonable physician” standard to a “reasonable patient” standard. However, consent forms have increasingly become lengthy as a defensive response to litigation, creating an information paradox that may not genuinely promote patient understanding. Drawing lessons from the development of UK case law, this article argues for re-centering consent on meaningful dialogue and shared decision-making. It concludes by proposing reforms that strengthen communication training, embed shared decision-making in clinical practice, and foster a trust-oriented culture.
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