機關鑑定之具結義務與醫療爭議評析之使用問題【月旦時論】 試閱
Oath-Taking Requirements in Institutional Expert Examinations and the Proper Use of Medical Dispute Evaluations
基於刑事訴訟法第206條第3項有關證據能力之法定程式的要求，部分機關鑑定委員會中之學者專家或社會人士倘不具備有系爭鑑定事項之專業能力者，即不應參與該鑑定事項之審議決定。其次，第208條第2項規定為確保囑託機關為公正誠實之鑑定所要求的具結與具名機制的透明化陽光，無法照亮醫療鑑定程序，令人扼腕。而立委提案修法試圖免除醫審會機關鑑定之具結義務，實與2023年12月修正刑事訴訟法改革鑑定制度的理念背道而馳，不僅不符合直接審理原則發現真實之目的，更可能不當損及被告詰問實施鑑定之人的訴訟防禦權．倘於個案審判中，被告對醫療鑑定之報告書面有爭執，法院未經傳喚實施鑑定之人於審判中到庭詰問，而逕依刑事訴訟法第208條第3項第2款規定採用醫審會未經具結之鑑定書作為認定被告有罪之證據者，因不當侵害被告憲法所保障之詰問權，恐有裁判違憲之虞。另外，醫療爭議調解過程中之評析報告內容，作為檢察官偵查、或於本案審判中作為法院審酌選任鑑定人或囑託機關實施鑑定的必要性、釐清系爭鑑定事項等必要範圍內的參考資料，並不違反醫預法第4條第4項規定．至於，審判外所製作之鑑定書，屬傳聞證據，除非符合例外容許之要件，否則應無證據能力。有無經過具結，應屬特信性的事由之一，而非絕對唯一條件，故不應僅因其未經具結，即適用第158條之3規定予以排除。
Pursuant to the statutory procedural requirements governing evidentiary admissibility under Article 206, paragraph 3 of the Code of Criminal Procedure, any scholar, expert, or lay participant serving on an examination committee of an institutional authority who lacks the requisite professional expertise with respect to the disputed subject matter should be excluded from participating in the deliberation or determination of that examination. Such procedural safeguards are essential to ensuring the reliability, neutrality, and admissibility of expert evidence within the criminal process. Moreover, legislative proposals seeking to exempt institutional medical examinations conducted by the Medical Review Committee from the obligation to testify under oath are fundamentally inconsistent with the normative objectives underlying the December 2023 amendments to the Code of Criminal Procedure, which were expressly intended to reform the expert examination system. By weakening theprocedural guarantees surrounding expert evidence, such proposals undermine the truth-seeking function embodied in the principle of direct adjudication and, more critically, risk unjustifiably impairing the defendant’s right to confront and cross-examine the individual responsible for conducting the examination. Where a defendant contests the substance or conclusions of a medical examination report, a court’s reliance on an unsworn examination report issued by the Medical Review Committee, without summoning the appraiser to testify and submit to cross-examination at trial, may constitute an impermissible infringement upon the defendant’s constitutionally protected right of confrontation. In addition, the contents of evaluation reports produced during the medical dispute mediation process, when utilized by prosecutors during the investigative stage, or by courts solely as reference materials within the necessary and circumscribed scope of determining whether to appoint an expert, whether to commission an institutional examination, or to clarify the specific issues to be addressed by the examination, their use remains consistent with Article 4, paragraph 4 of the Medical Malpractice Prevention and Resolution Act.
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