【醫療刑事法】藥源性史蒂文強森症候群案:醫師違反告知義務之刑事責任【學習式判解評析】 試閱
Medical Criminal Law: The Case of Drug induced Stevens-Johnson Syndrome
裁判字號 臺灣最高法院101年度臺上字第2637號刑事判決
被害人X經被告醫師Y診斷為神經根病變,回診時因疼痛而改以Tegretol藥物治療,惟疏未說明可能之副作用並徵得同意。藥政局曾函示該藥有造成史蒂文強森症候群之案例,若用於非核准適應症時不予藥害救濟。X經續開該藥四週,呈現紅疹、口腔潰瘍併膿樣分泌物,並持續發燒、血尿等,後終因前揭症候群死亡。法院指出,未依規定告知固屬醫療自主權之侵害,但有無醫療過失仍依是否遵循醫療準則為斷,本件告知既無助於防止危害,難責被告Y過失責任。
對於違反告知義務是否應對後續之醫療傷害負擔過失責任,實務有不同意見,然而法院宜應考慮病人接受藥物治療之意願;又違反告知說明義務之責任與錯誤、不當醫療行為之過失責任分屬不同推理體系,不宜混為一談。
The victim X was examined radiculopathy by the physician Y, and took the therapy with the medicine Tegretol because of hurt when visiting back. However, the Y didn’t explain the possible side-effect and didn’t get X’s confirmation. Because this drug might induce Stevens-Johnson Syndrome, the bureau of drug administration insists that a patient, which took this medicine shall not belong to the drug injury relief, if it was used in unapproved illness. The X has taken this medicine for four times and has had rash, oral ulcers with pus. He also got fever and hematuria; he dead as the result. The court deemed whether the physician Y had the medical fault, is depend on whether he obeyed the medical rules, even though it was a violation of the autonomy of the medical treatment. Because the notification in this case was helpless to interfere the danger, the Y had no fault.
Although courts have different opinions about whether the physician has fault about the medical injuries forwards, if he disobeyed the duty of the explanation, they should considerate the willing of taking medicine as the treatment. Furthermore, the responsibility of disobeying the duty of the explanation and the responsibility of the fault and the improper medical treatment shall be different.
116-152