期待権侵害に関わる医事裁判例

Abstract

医療過誤における医師の法的責任は,原則として,医師の注意義務違反・患者の損害発生,医師の注意義務違反と患者の損害との間の因果関係の3者がそろった時にのみ追及される.しかし,この3者の中で因果関係が認められない場合でも,適切な医療を求める患者の期待を裏切ったとして,医師は損害賠償義務はないとしても慰謝料を払わなければならないことがある.この考え方は「期待権」侵害と称される.医事訴訟における期待権侵害を肯定する判例は,昭和51年以降注目されているが,このような判例についての最近のレビューとしての報告はない.本稿においては,最近の判例に焦点をあてて,期待権侵害に関わる医事判例の概要を把握し,解析することを目的とする.昭和22～平成13(1947～2001)年の誌上公開判例を収集した判例データベース判例マスターを用い, "期待権"あるいは"期待権侵害"をキーワードとして該当判例を抽出した.抽出された判例は,56判例51事例であり,控訴審8例・上告審1例を含んでいた.上級審での判断が少ない点に特徴があるが,最高裁においても期待権という概念が使用されている.全体では,期待権侵害が肯定された判例が41例,否定された判例が12例であり,肯定判例が優勢である.期待権侵害を肯定する判例では,債務不履行責任・不法行為・債務不履行と不法行為の双方を法的根拠とするものがほぼ等数であった.期待権の内容は,時代の変遷に伴って変化し,延命のみならず,後遺障害等を含むものとなり,最近では「適切な治療を受ける権利」として把握されている.更に,期待権侵害の肯定判例における慰謝料の認容額は低額にすぎることが指摘され,最近では高額化してきている.期待権等侵害医事判例においては,医師の賠償責任が拡大される傾向にある.The legal responsibility of a physician in a medical malpractice case is investigated only when three elements-medical negligence by a physician in exercising proper caution and performing his duty, damage suffered by the patient, and the cause-effect relationship between the aforementioned medical negligence by the physician and the damage suffered by the patient-are proven. However, even when the cause-effect relationship among the aforementioned 3 elements is not recognized and the physician is deemed not obligated to compensate for damage, he may be required to pay consolation money to the patient because the former failed to meet the expectations of the latter, who had expected appropriate medical care. Such a concept is called infringement of the "right of expectation". From the Hanrei Master, a database of judicial cases, appropriate cases were extracted by using "right of expectation" or "infringement of the right of expectation" as keywords. Characteristically, there are few that are judged by the upper courts but the concept of the right of expectation has been adopted by the Supreme Court. On the whole, infringement of the right of expectation was upheld for 80% cases. Among the former, non-fulfillment of obligation, illegal acts, and both of these were, on a legal basis, generally equally represented. Delay or negligence in providing adequate medical care due to nonperformance by the physician was cited for many cases. The content of the right of expectation is not limited to prolonging one's life: it also includes the significance of sequelae. Recently, this right has been construed to mean the "right to receive appropriate medical treatment". In addition, it was recently pointed out that monetary compensation for the cases upheld for infringement of the right of expectation was too small, which resulted in raising the amount of money awarded