篇名

不符醫療水準之第二次手術的假設同意【寰宇醫事裁判】   試閱

並列篇名

The Hypothetical Consent of the Second Surgery Which Was Incompatible with Medical Standards

中文摘要

被告為美容外科醫師,首為患者A進行第一次抽脂手術,並履行術前告知抽脂與麻醉風險之義務,而獲得患者A的同意。其後,在被告建議下患者A進行第二次抽脂手術,此時被告卻未告知手術風險。況且被告僱請未經訓練之化學系學生為其協助手術施行,並自認有能力對患者A進行生理監測。然而被告過量使用藥物,且未注意患者A已有呼吸抑制之前兆,同時急救準備不足,致患者A最終死亡。本案經邦高等法院認為被告並非故意傷人致死,而基於患者A的假設同意,毋寧是過失傷人致死。經被告與患者A之妻提起上訴,聯邦最高法院撤銷邦高等法院之判決。聯邦最高法院認為,醫療手術乃故意傷害行為,在未告知手術風險、病程、成功率等情況下,若可假設有告知而患者依然同意,則此時具有假設同意,而該手術不具違法性。然而若無進一步之告知,患者的同意僅限於依醫療水準所施行之手術。因此對第一次手術的同意,並不及於第二次手術的假設同意。本案第二次抽脂手術並不符合醫療水準,且在審酌患者有無假設同意時,應考量到患者即使知道第二次抽脂手術之準備不如第一次抽脂手術,則是否依然同意。準此,聯邦最高法院認為本案並無假設同意,故被告施行的第二次抽脂手術,仍是具違法性之故意傷害行為。

英文摘要

As a cosmetic surgeon, the accused performed the firstliposuction for the patient A, informing the risks of theliposuction and the anesthesia according to the obligation.The patient A consented as well. After that, the patient Aunderwent the second liposuction because of the accused’ssuggestion. However, the risks of the surgery wasn’tinformed this time. Besides, during the second liposuction,the accused hired an undisciplined chemical student as anassistant of the surgery which thought that he was capableto monitor the patient A’s physiological condition. Theaccused overdosed A, ignoring that there was a sign ofthe suppression of A’s breathing. Furthermore it was lackof preparation for the accused to response the emergencyduring the surgery. A dead eventually. According to theHigher Regional Court, the accused didn’t mean to injurythe patient A to death. On the ground of A’s hypotheticalconsent, what the accused did was rather negligenceinjuries to death. After the accused and the patient A’s wifeappealed, the supreme court invoked the judgment made bythe Higher Regional Court, deeming that, since the surgerybelongs to an intended injury, the consent of the patientcould only be hypothetically valid and the surgery wouldnot be illegal on the ground of the hypothetical consent,when the patient might still consent, even though the risksof the surgery, including medical courses and the survivalrate, were not informed. Nevertheless, if there was nofurther informing, the consent of the patient was only validin respect of the surgery which was performed accordingto the medical standards. The validness of the consentfor the first surgery couldn’t extend to the second one, asthe hypothetical consent. The issued second surgery wasincompatible with the medical standards. Besides, duringthe reviewing the hypothetical consent of the patient, itshould be taken into consideration whether the patient Amight consent to the surgery, even if he knew the secondsurgery was less prepared than the first. In this regard,the supreme court figured that there was no hypotheticalconsent in the issued case and the second liposuctionperformed by the accused was still an illegal intendedinjury.

起訖頁

115-121

出版單位
DOI

10.3966/241553062021010051009  複製DOI  DOI查詢

QRCode

數位整合服務
產品服務
讀者服務專線:+886-2-23756688   傳真:+886-2-23318496   地址:臺北市館前路28號7樓

Copyright © 元照出版 All rights reserved. 版權所有,禁止轉貼節錄
TOP