無照行醫的法規範檢討

Abstract

我國的以行政刑法制定無照行醫的刑事處罰，其犯罪的構成要件中是以醫療行為的肯否為判定的核心的。為了迎合無照行醫罪的判定輕重的拿捏，主管機關與司法判決迭將醫療行為作極為限縮的解釋。有以致之，使得在現有的法令規範中，對於醫療專業的扶持與管制，對於醫療行為認知觀念的偏差，到了無以復加其重的地步。\n醫療行政管理的最終極目的，就是要為人民提供值得信賴的、安全的、有品質的醫療。醫療是高度專業的社會行為。專業行為的管理核心，應當在該專業的自律。自律的依據應在自律公約。另一方面，政府對於專業事務的管理，應在於監督專業團體的自律，以為民眾做把關。對於侵害專業自律團體的情事，應以公權力予以規範管制或是禁止，進而懲罰違反規範的人。\n但是，侵害專業自律團體的情事或行為，並非是對於刑事上法益的侵害，當然就不宜用刑事的規範來予以刑求。訂一個無照行醫罪，以刑事來處罰，牽強地用抽象危險的罪名，又加一個集合犯的業務構成要件，來處罰這樣的侵害專業自律團體的情事，猶如用巨砲打小鳥，成效不彰，卻又引來對於專業自律團體的自律規範的侵蝕。對於專業自律團體而言，這樣的一個刑事規範，表面上是落得輕鬆，其實質上，卻是一件得不償失的事情。\n本篇論文的主要目的，期盼藉由上開各個面向的探討與法律制度的論述，檢視醫療行為在法律規範當中所應被對待的認識，以供醫界、法界及相關行政主管機關參考。對於醫療系統性的管理能夠以適情順理合法的規範、而為人民提供值得信賴的、安全的、有品質的醫療，造福百姓大眾。\n如何適切修正現有法令規範的限制，讓現有對於醫療行為狹隘的詮釋，得到抒解，讓人民有醫療友善的環境，獲得醫學科學進步更深更廣的益處，是筆者一直深切期待的。台灣醫療體系面臨的困境，是由於多數人對於醫療的認識太過貧乏或偏頗；其所造成的影響尤在於國人對於基本常識性的醫療知識與認識不足，導致於醫療上正確的作為，經常被沒有科學證據所驗證的民俗療法所凌駕。本文將剖析其源由，端由其不當的法規範所引發出來的對醫療認知偏差的規範評價。從制度面與實際執行面的差異，並提出草擬的修正條文以供修法之參考。

The purpose of administrative regulation in medical practice is to warrant a systemic healthy medical service-providing environment to ensure an accountable, safe, good quality medical service for people in public.\nMedical service is a highly professionized activity in a society. The core spirit of a profession is self-management with self-discipline. Nevertheless, the role of government to administrate the profession of medical practice affairs as gate keeper is to supervise the execution the self-discipline convention of the profession bodies. The public power holder is obliged to set the regulation and punishes those who violate the provisions to damage the self-disciplinary bodies.\nHowever,, the damage to profession body is not an issue of criminal violation, would not be appropriate to pay the punishment with criminal penalty. To set unlicensed practice of medicine accompany with a condition of business setting medical service as a crime, for the reason of abstract dangerous to the public is,using a canon to shot a bird, out of proportionality, and yet,corroding the self-disciplinary professionism. To a professional body acriminal law setting like this, is only to release it’s accountability with a negative return.\nUnder the effect of the current law, the administrative concept to medical conduct is distorted to a level hard to be mended.\nHow to amend the regulation to turn the narrowed interpretation of medical conduct around, to make the public benefit from the scientific advancement in a medical friendly environment is always what this writer`s expectation. The obstacles in the medical service system that we face today in Taiwan, is rooted from the lack of awareness and distorted interpretation to the modern medicine. This further makes folks of this nation have only poor health or medical commonsense, only to be led by unscientific folk therapy wrongfully prevailing. This article is to analyze the misinterpretation of medical conduct may partly sourced from the wrongful set law. Thus, enhances the distortion of the value to the medical diagnostic and therapeutic activities. Here, is tried to provide an amendment to the article to affix the issue from both the statutory and executive aspect comprehensively.