時論-讓醫生安心與上帝拔河 – 中時電子報
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時論-讓醫生安心與上帝拔河
2015年06月02日 04:10
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行政院版的「醫糾法」在醫界強烈反彈下,立法院本會期要通過的可能性幾乎為零。但是衛福部為什麼要積極推動「醫糾法」?因為近年來高風險醫療科系大家視為畏途,未來有可能形成斷層,全民都成受害者,這才是衛福部心中的焦慮。目前投身於高風險醫療科系的壓力,來自工作繁重、時間又長、沒有正常的生活,健保相關給付又偏低,完全不符投入的心力,如果發生醫療糾紛,又要承受家屬的攻擊抗爭,以及冗長無止境的司法糾葛,同時還要持續承擔壓力繁重的醫療工作,雙面夾擊煎熬,彷佛陷入煉獄,最後的司法判決可能還要負擔沉重的賠償責任,也許一次就永遠無法翻身。試問有誰願意投入這樣的職場?
時論-讓醫生安心與上帝拔河 - 中時電子報
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行政院版的「醫糾法」在醫界強烈反彈下,立法院本會期要通過的可能性幾乎為零。但是衛福部為什麼要積極推動「醫糾法」?因為近年來高風險醫療科系大家視為畏途,未來有可能形成斷層,全民都成受害者,這才是衛福部心中的焦慮。目前投身於高風險醫療科系的壓力,來自工作繁重、時間又長、沒有正常的生活,健保相關給付又偏低,完全不符投入的心力,如果發生醫療糾紛,又要承受家屬的攻擊抗爭,以及冗長無止境的司法糾葛,同時還要持續承擔壓力繁重的醫療工作,雙面夾擊煎熬,彷佛陷入煉獄,最後的司法判決可能還要負擔沉重的賠償責任,也許一次就永遠無法翻身。試問有誰願意投入這樣的職場?
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面針對惡劣的工作環境,應該積極推動醫師全面納入勞基法,對於高風險科系的醫療作業投入足夠的資源,調整其合理給付,以符合投入的心力。針對醫療工作者心理上威嚇力強大的醫糾事故,要提出解決辦法。因此,衛福部「醫糾法」的內容應涵蓋兩個核心架構:一是司法扶助系統,編列基金成立專業法律團隊,針對發生醫糾事故的醫療工作者,完全接手其醫糾相關事務,讓其安心的在工作崗位上持續服務。二是編列預算作為「醫療補償基金」,解決其賠償責任。完全解除醫療工作者的醫糾責任,各界當然會有爭議,因此,必須限定範圍。建議以提供必要醫療服務的健保服務為範疇,同時只限定用於醫療工作者於非故意,沒有違法、沒有違反醫療常規的相關案件,就是只要醫療工作者依法、依其訓練常規,合理的處理病患,即使事後檢視認為當時的診斷或治療的選擇並不正確,或執行中發生非故意之失誤,但因面對急迫的病患變化,在有限的時間壓力下執行作業,我們應該允許也接受這樣的事實,承認這是在從事醫療工作與上帝拔河的必要風險,應屬整體醫療服務的必要成本,全民願意承擔。這樣明確限定範圍的醫糾事故,由公部門提供「司法扶助」,由健保編列預算,針對最後判定確有過失的案件給予補償,才能徹底解除醫糾的心理威嚇。(作者為台灣私立醫療院所協名譽理事長),