以臺灣高等法院民事判決104年度醫上字第9號為例──試論高齡社會下擴張的醫療照護責任及其法制對策【醫法新論】 試閱
A Study on the Expanding Medical Liability and Medical Dispute Resolution in an Aging Society
據統計，臺灣即將正式邁進「高齡社會」，2025年更會成為老年人口占比20%的「超高齡社會」；此外，身心障礙者的人數在過去10年間亦持續增加，其中，65歲以上之慢性精神病患（含失智症等）更從2006年的7237位增加至2016年的16798位，而在未來6年內，失能失智患者也將從每日增加60位提升至每日約85位。日漸沉重的照護壓力，考驗的不只是家庭能否負擔，在此同時，醫療機構亦須對此一社會狀態的改變作好充分的準備。參考他國經驗，1999年日本曾發生多起醫院之高齡者醫療事故，其主因在於高齡者於日常生活中常有跌倒、誤嚥食物等危險，加上可能因家庭無力負擔照護工作，而有「社會性入院」現象，導致推遲出院；在醫護人力短缺的今日，若家屬一昧地將高齡失能者留置醫院，卻誤以為此舉能同時滿足醫療與照護需求，除徒增血汗醫護的負擔外，更可能置應受照護者於更加不利的地位。本文以高齡失能患者於長期住院期間發生噎食致死之案例，分述於高齡社會下的醫療照護責任與可能之因應，以供國人對策參考。
According to population study, Taiwan will soon become the “aged society” and will become the “hyper-aged society” in 2025 which means that the elderly population reach to 20%. Moreover, the population of mental and physical disabilities was increasing in the past decade. For example, the population of chronic mental disables over 65 years old (including dementia elderly patients) increased from 7237 in 2006 to 16798 in 2016. In the next six years, elderly patients will increase from 60 per day up to about 85 per day. The more and more heavy pressure of taking care elderly patients not only impacts their family but also medical care institutions elderly patients may have danger in swallowing and falling, thus there are many accidents happened in hospitals. Furthermore, there is a “sociality admission” phenomenon that their family wishes elderly patients to stay in the hospital because their family are not capable to take care of them. Nowadays, we do not have sufficient medical resources to confront with this problem. If all family send elderly patient in medical institution, it may either increase the pressure and responsibilities to medical professionals and put elderly patients in a worse situation. Thus, this article will start with a case of an elderly patients die from swallowing when in he was in hospital within the admission period, and then go to the discussion of responsibility of medical professionals and institutions and relating policy.
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