從同儕自律到公眾保護：借鏡英國醫師監管制度論病人安全的實踐【本期企劃】 試閱
From Peer Regulation to Public Protection: Lessons from the UK Medical Regulatory Framework for Enhancing Patient Safety
我國醫師懲戒制度面臨之困境，包含同儕自律引發的利益衝突、啟動門檻不明確以及審議透明度不足等問題，且現行制度多著重於事後懲罰，難以回應社會對病人保護的即時期待。對照英國監管體系則是以「公眾保護」為核心目標，並透過「執業適任性」建立分層治理架構，最終並以「矯正與繼續教育」形成閉環管理。本文建議我國應借鏡此英國監管架構，以建立公正文化並將懲戒制度與病人安全結合，建構更具公信力的醫療治理體系。
Taiwan’s medical disciplinary system faces significantchallenges, including conflicts of interest arising from peer regulation, ambiguous initiation thresholds, and insufficient transparency in deliberations. Furthermore, the existing framework focuses heavily on retrospective punishment, making it difficult to fulfill society’s real-time expectations for patient protection. In contrast, the UK’s regulatory system establishes “Public Protection” as its overarching objective and builds a layered governance framework through the “Fitness to Practise” mechanism, ultimately achieving closed-loop management via “remediation and continuing education.” This article suggests that Taiwan should draw lessons from the UK’s regulatory structure to foster a just culture and integrate medical discipline with patient safety, thereby constructing a more credible healthcare governance system.
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