家屬拒絕病患插管案：關於自主決定權為侵權客體【學習式判解評析】 試閱
Intubation Refusal by Patients' Family: Related with Self-Determination as the Object of Tort Liability
自我決定意謂著自我實現者具有的自主性，而不受環境的支配。自主決定權即為「在不對他人權利造成侵害之行為，僅為自己人格發展有關的私人事項，自己可以獨自作決定之權利」。在醫病關係中，醫師需對病患提供有關治療上正確且充分的資訊，且須以病患能夠理解的方式慎重、仔細的說明，以確保病患能夠在自由選擇的環境中作出最好的決定。所謂「告知後同意」原則，是一個由醫師進行說明，而病患加以理解，接著共同作出決定的醫病連續互動之流程。本文首先介紹自主決定權之意涵與醫師違反說明義務，切入告知後同意法則之雙重意義，即一方面保護病人自主決定權，另一方面作為侵權行為違法性之阻卻違法事由，次則論述醫師違反說明義務之法律效果，包括侵權責任之概念、構成要件與違法性之論述，最後討論病患代理人參與醫療決定及病患代理人參與醫療決定之規範內容，以評析探討目前我國司法實務對於此「家屬拒絕病患插管案」判決。
Self-determination means the autonomy of a self-actualized person in an independent of environment. The right to self-determination is the right to make decisions on one’s own, provided that the behavior does not infringe the rights of others and is only in one’s private matters related to his / her own personality development. In doctor-patient relationship, doctors need to provide correct and sufficient information about medical treatment to the patients, and they must explain carefully in a way that the patients can understand, so as to ensure that the patient can make the best decision in an independent environment. The principle of “informed consent” is a continuous interaction process between doctors and patients, in which the patients can understand well and then make an independent decision. This article firstly introduces the meaning of the self-determination right and the physician’s violation of the legal obligation, and then discusses the dual meaning of principle of informed consent, on which patients can protect the self-determination right, and on the other hand, it can serves as an object of tort liability. This article also discusses the legal effects of a physician’s violation of the legal duty to disclose medical Information, including. the concept, the constituent elements and illegality of tort liability. Finally this article discusses the participation in medical decisions of the patients’ surrogate, and analyze the current judicial judgment on this “A case of Intubation Refusal by Patients’ family”.
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