牙科根管治療爭議案：未使用橡皮障之根管治療與醫療鑑定之司法審查【學習式判解評析】 試閱
Medical Malpractice in Dental Root Canal Treatment : Judicial Review of Medical Expert Opinions in Root Canal Treatment Without the Use of a Rubber Dam
本文以未使用橡皮障之根管治療案例為中心，探討法院對醫療鑑定意見之採信界限，並檢討病人自主權利法施行後告知義務之判斷標準。本文認為，醫療鑑定雖具專業性，但仍屬證據方法之一，法院不應僅因鑑定機關具權威性即逕予採納，應就其文獻基礎、病歷依據、論理一致性及是否符合主流醫療常規為實質審查。就本案而言，未使用橡皮障是否符合醫療常規，尚有再檢討空間。又病人自主權利法施行後，告知義務之判斷應由傳統理性醫師標準，轉向以病人自主決定為核心之理性病人標準，凡足以影響病人醫療決策之風險與替代方案，原則上均應納入說明範圍。
This article examines a root canal treatment case in which no rubber dam was used, focusing on the limits of judicial reliance on medical expert opinions and the standard for determining the physician’s duty to disclose under the Patient Right to Autonomy Act. It argues that although medical expert opinions are highly specialized, they remain a form of evidence and should not be accepted solely because of the authority of the expert institution. Courts should conduct a substantive review of their academic foundation, medical-record basis, logical consistency, and conformity with mainstream medical standards. In this case, whether treatment without a rubber dam satisfied the applicable standard of care remains open to question. Furthermore, after the enactment of the Patient Right to Autonomy Act, the standard for disclosure should shift from the traditional reasonable physician standard to a reasonable patient standard centered on patient autonomy. Risks and alternatives that may affect a patient’s medical decision should, in principle, be disclosed.
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