Arzthaftungsrecht in der Bundesrepublik Deutschland

Abstract

[[abstract]]德國醫師責任法分為兩個面向：醫師的診療責任及醫院的住院醫療責任。醫師的診療責任又可分為：依民法特別規定—診療契約所生之債法上責任，以及依民法規定的侵權行為責任。此外，債法上責任依病患身分（私人醫療保險病患、法定醫療保險病患、社會救助受領者）及疏失行為（診療疏失、告知疏失）而有所不同。 在住院醫療方面須區分為：私立醫療院所、公益醫療院所、公立醫療院所。病患於住院之前就必須締結住院醫療契約，其性質原則上為民法的勞務契約。住院醫療契約可分為三種：單一式住院醫療契約、單一式住院醫療附加指定醫師契約、住院醫療與醫師診療分離式契約。在契約責任方面尚可分為醫院及醫師的責任，而侵權行為責任的分類，亦同，且醫院還要為其機關及履行輔助人的行為負侵權行為責任。在公立醫院也一樣分為醫院及醫師的契約責任、侵權行為責任。 在起訴前得就醫師責任爭議提付仲裁。提出請求權之病患須證明存在醫療疏失、法益侵害、受有損害，以及醫療疏失與健康受損之間的因果關係。至於負責診治的醫師須證明已依規定向病患進行告知。發生重大醫療疏失時會產生舉證責任倒置的效果，醫生因此要承擔舉證責任可能帶來的敗訴風險。 Medical malpractice law in Germany ascribe medical liability to doctors and hospitals respectively. The doctor's liability is further categorized as obligation under the special provisions of the treatment contract in the German Civil Code and tort liability under the German Civil Code. Contractual liability differs according to the patients‘ status (private patients, health insurance patients and welfare recipients), treatment errors and incorrect medical advices. With respect to hospitalization, there are options of private hospitals, non-profit hospitals and public hospitals. A hospital contract must be closed prior to hospitalization. The contract is a civil law contract of labor by nature. Hospital contracts are categorized as follows: the complete hospital contracts, the complete hospital contracts with additional physician contracts, and the separate contracts. Contractual liability is assumed by hospitals and/or doctor, and the same with tort liability. The hospital is also liable for their assistants and institutions. Contractual and tort liability is assumed by hospitals and physicians respectively in public hospitals as well. Before an action is brought, the arbitration board may be called for medical liability issues. A patient who submits a liability claim has the responsibility to provide proof of treatment errors, violation of rights, the damages and the causal link between medical malpractice and health damage. The attending physician has to prove that he had explained the medical process to the patient properly. Gross errors in treatment may cause a shift in the burden of proof, and as a result, the physician might run the risk of evidence