陳忠五2006-07-252018-07-052006-07-252018-07-052002http://ntur.lib.ntu.edu.tw//handle/246246/12838民事法上之債權擔保制度，無論是人的擔保制度（如各種保證契約）或物的擔保制度（如 抵押權、質權等擔保物權），目的均在確保債權人之債權獲得實現滿足。債權人之所以能利用 這些擔保型態確保其債權，通常有一前提：債權人與債務人間先有交易接觸，得以事前透過談 判，組織、安排或設計符合雙方當事人需要之擔保型態。然而，此一前提在各種因「意外事故」 （accidents ）所生損害賠償之情形，通常不存在。基於意外事故之「偶發」、「不確定」、「不可 預見」之特性，被害人與加害人間一般均無法經由事前接觸談判，組織、安排或設計足以確保 被害人之損害充分、迅速、確實獲得填補之擔保制度。其結果，意外事故發生後，被害人之損 害往往不易獲得填補。 醫療事故即是明顯的例子。因醫療事故所生之損害賠償請求權，性質上雖然是一種債權， 但由於醫療事故是一種意外事故，被害病患或其家屬於事故發生後，其損害大多不能經由債權 擔保制度獲得填補。於此情形，除非醫療事業機構或醫事人員願意主動填補被害人損害，否則 被害人除提起民事訴訟追究賠償責任之外，別無其他方法可以獲得損害填補。從我國許多醫療 糾紛民事訴訟案例可以看出，在極端複雜與專業之現代醫學科技下，一個身體、心理甚至經濟 上已受創嚴重之被害人，面對一個在專業知識、技術與經濟地位上大多處於強勢或優越地位之 對造當事人，由於其通常欠缺足夠之時間、金錢或精力搜集有關證據資料，加上繁瑣複雜之專 家鑑定、訴訟程序之長年拖延、訴訟過程之疲憊勞費，往往又必須面對一個相當不確定或敗訴 機率偏高之訴訟結果。 基於「醫療責任民事訴訟不能妥適填補被害人損害」之認識，本研究計畫擬捨棄傳統民 事責任法之思考模式，改從「如何確實填補被害人損害」之角度出發，在兼顧「正義」與「效 率」之原則下，尋找我國「現有」、「擬議中」或「未來可能採用」之各種足以「擔保」被害人 損害確實獲得填補之制度（例如，醫療責任保險、藥害或疫苗接種救濟制度、醫療事故特別補 償基金等），檢討各種制度之利弊得失，及其在我國現時社會施行之可行性，並提出立法上或 解釋上可以追求之方針。Owing to the uncertainty and unpredictability of accidents, there is no warranty system between victims and inflictors that can compensate victims through negotiation, organization or arrangement. Consequently, the injuries of victims cannot be met once the accident happens. Medical accident is a good example for this. Unless the hospitals and doctors are willing to assume the responsibility, the victims cannot help but to file a lawsuit to get compensated. Observing the medical disputes cases in Taiwan, we can discover that the victim, physically, mentally, and even economically injured, is usually faced with a result full of uncertainty and high possibility of losing, for the lack of money and time to acquire related evidence and information, for the trivial and complicated expertise appraisal, and for the tedious and tiring legal proceedings. Knowing that civil lawsuits cannot properly compensate the victims, we drop the traditional legal thinking of civil liability and put much emphasis on how to properly compensate the injuries of victims. We explore this issue with considerations of both justice and efficiency and look for the very system that is sufficient to warrant the injuries of victims to be properly compensated, such as medical liability insurance, compensation of drug failures and inoculation and special compensation fund of medical accidents. The advantages and disadvantages of the various systems and the feasibility in our present society are thoroughly discussed. Last, we also propose some principles on legislative and explanatory aspects.application/pdf159384 bytesapplication/pdfzh-TW國立臺灣大學法律學系暨研究所醫療事故醫療糾紛損害填補擔保制度medical accidentmedical disputecompensationwarrantyreporthttp://ntur.lib.ntu.edu.tw/bitstream/246246/12838/1/902414H002030.pdf