課程：醫療與法律ppt课件

1、國立高雄第一科技大學科技法律研讨所 案例討論課程：醫療與法律指導教授：周天 所長報 告 人：碩專班二年級 9520708 孫慈和 CASE 13 HELLING v. CAREY 案例事實原告為被告所治療的病人，因為身為眼科醫師的被告未能適時診斷並治療其所罹患之青光眼，致其呵斥永久的視力損傷，因此對被告提起醫療業務過失(Malpractice action )之訴。 案例事實History(1)1959 for myopia, nearsightedness. At that time she was fitted with contact lenses. September,1963, co

2、ncerning irritation caused by the contact lenses. October, 1963February, 1967; September, 1967; October, 1967; May, 1968; July, 1968; August, 1968; September, 1968; October, 1968. 案例事實History(2)October 1968 consultation, the defendants considered the plaintiffs visual problems to be related solely t

3、o complications associated with her contact lenses. On that occasion, the defendant, Dr. Carey, tested the plaintiffs eye pressure and field of vision for the first time. This test indicated that the plaintiff had glaucoma. The plaintiff, who was then 32 years of age, had essentially lost her periph

4、eral vision. 程序In August of 1969, the plaintiff filed a complaint against the defendants alleging that she sustained severe and permanent damage to her eyes as a proximate result of the defendants negligence. The trial court entered judgment for defendants following a defense verdict, the Court of A

5、ppeals, Division I, James, J., affirmed, and the patient petitioned for review. Morrison P. HELLING and Barbara Helling, Thomas F. CAREY and Robert C. Laughlin plaintiff 侵權行為defendants Malpractice action the Court of Appeals affirmedSupreme Court of Washington, En Banc. trial court entered judgment

6、for the defendants following a defense verdict trial court原告主張(1)下級法院對於陪審團有關定義眼科醫師standard of care之採證標準有誤。(2)下級法院關於該standard of care之採證標準無法保護原告免於受青光眼疾病之害。(3)被告未能於早期對原告作眼壓試驗，以防止呵斥原告不可回復之傷害，為過失。被告主張對於40歲以下的病人，由於青光眼發病機會相當低，就眼科執業的標準而言，並無作常規眼壓試驗的規定，因此無需對於原告罹患該疾病的結果負過失責任。專家證言(1)該疾病於40 歲以下極少發生。 (2)就眼科執業的標準

7、而言，對於40歲以下的病人，並無作常規眼壓試驗的必要。(3)就眼科執業的標準而言，假设病人主訴與症狀顯示有懷疑是青光眼的能够時，則眼壓試驗是必須的。 爭點被告按照眼科執業的標準，未能及時對於原告作眼壓試驗以早期診斷青光眼，致使原告永久喪失大部分視力，對於該結果被告能否主張免責?判決Defendants were negligent as a matter of law in failing to administer a simple glaucoma test to the patient despite uncontradicted expert testimony that it was

8、 the universal practice of ophthalmologists not to administer glaucoma tests to patients under age 40 because the incidence of glaucoma at younger ages was so small. 判決理由1Justice Holmes stated in Texas & Pac. Ry. v. Behymer, 189 U.S. 468, 470, 23 S.Ct. 622, 623, 47 L.Ed. 905 (1903):What usually is d

9、one may be evidence of what ought to be done, but what ought to be done is fixed by a standard of reasonable prudence, whether it usually is complied with or not.常規的作為也許是應所作為的証明，但是對於應所作為而言，不论其能否被遵守，應謹守於合理謹慎的標準。判決理由2In The T. J. Hooper, 60 F.2d 737, Justice Hand stated:在大部分的案例中reasonable prudence事實上就是common prudence，但是嚴格言之並不把它當成是一衡量標準。reasonable prudence 不用設定其檢測試驗，但是其运用的場合必須具有說服力。假设其預防措施是絕對必要的，則即使是為大家普遍性所被忽視的的情形，也不能因此而對其忽略主張免責。判決理由3基於本案例事實 (1)適時對於原告施予眼壓試驗屬於reasonable prudence(2)眼壓試驗對於40歲以下的青光