| 摘要註: |
行政院衛生署於民國八十五年六月底開始核准第一批提供民眾人工協助生殖技術服務機構，迄九十六年十一月止共核准七十六家人工協助生殖技術機構。依國民健康局的統計民國九十五年施行人工生殖的有7,281人，其中有懷孕的有2,727人，而懷孕人數中只有2,022個有活產 。施行人工生殖的成功率為37.45％，活產的比率更只有27.77％，可見目前社會有不少家庭因為人工生殖而有孕育下一代的希望，但是施行人工生殖之成功率並不高，然若人工生殖醫療過程有所疏失，致產生非所預期之後代，如子女有疾病、誤植精子、誤植受精卵等，此種失誤造成做人工生殖夫婦之精神上折磨及經濟上的支出，得否對醫院及醫生主張瑕疵擔保責任或債務不履行而請求損害賠償？可否請求回復原狀？其理論構成基礎為何？實際案例又如何？均值得探討。民國93年4月醫療法之修正，確立醫療行為為民事過失責任原則後，通說認為已排除消費者保護法的適用，雖然目前人工生殖法規定施行人工生殖限於夫妻，但近來有單身女性 願意借助人工生殖產子，所以因社會發展、尊重女性生育自主權等問題的提出，使得人工生殖不再單純的只是治療不孕症的醫療行為，其可能漸成為一種使用醫療技術的消費行為，是否有消費者保護法的適用也是值得再研究。又行政院於2007年7月通過之「醫療服務國際化旗艦計畫」，開放大陸人士來臺接受我國甚具國際競爭優勢的「五大強項」醫療服務，其中人工生殖亦為其中之一，可見將來亦可能與大陸人士發生有關人工生殖契約之問題，所以有關人工生殖契約之權利義務關係之研究有其重要性。人工生殖契約雖為醫療契約，但有其特殊性與一般醫療契約有別，也因為對於人工生殖的不了解，而無法清楚的適用法規或法理，使得醫病之間所產生的法律問題無法完善的解決，所以本文就針對人工生殖契約之契約責任做一研究，並期能提供相關之建議，期待透過本研究有助於對人工生殖契約之內容、性質與當事人間之債權債務關係之釐清，期許醫界能更了解人工生殖契約的法律上責任並善盡其責，也期許接受人工生殖之受術夫妻能清楚其權益並與醫者配合共同創美好的生命。醫療事故處理的難處，常是由於對醫療行為不了解，導致在法規或法理的適用上，有窒礙難行之處。所以對醫療行為特殊性質的瞭解，實為探究醫療契約的第一步。本文首先對人工生殖的意義、特性及程序作深入的介紹，列為第二章。醫療契約的性質，以往有委任、承攬、僱傭或無名契約等爭議，本文於第三章針對人工生殖契約之性質作討論並提出本文見解。於第四章、人工生殖契約之債務不履行與瑕疵擔保責任，則先論及人工生殖契約瑕疵之成立與內容、瑕疵之免除、約定加重或減免瑕疵擔保責任及瑕疵擔保之效力與期間。次就人工生殖契約所可能產生之債務不履行之問題分析說明，試於第五章、消費者保護法之適用，先討論傳統醫療契約適用消費者保護法的問題及實務上之見解，並說明民國九十三年醫療法修訂後之變動，再依人工生殖契約有別於一般醫療契約之特殊性討論適用消費者保護法與否，並提出看法。最後於第六章、結論，對人工生殖的契約責任作一總結的說明並提出本文見解。 Department of Health, Executive Yuan approved the first service agency providing public artificial reproduction technique by the end of June in 1996. There were total 76 reproduction technology service agencies approved as of November 2007. According to the statistics of Bureau of Health Promotion, there were 7,281 persons performing artificial reproduction technique in 2006. Among them, 2,727 persons were pregnant and only 2,022 born alive among pregnant women . The successful rate of artificial reproduction technique was 37.45%, while the rate of born alive was even only 27.77%. It is thus evident that artificial reproduction technique has ignited the hope of many families for breeding next generation. Unfortunately, the successful rate is low. In case that there is negligence during artificial reproduction technique process resulting in unexpected offspring such as disease, mistaken sperm or fertilized egg, such mistake would torture the couple processing artificial reproduction technique in mentally and economically. Could they claim damage compensation due to liability for warranty against defects or default on liability to the hospital and doctor? Claim for restoring to original state? What is the theoretical basis? What about the actual cases? They are all deserved for discussion.The amendment of Medical Care Act in April 2004 had exempted the application of Consumer Protection Act due to confirmation the civil negligence liability of medical malpractice. Though Artificial Reproduction Act is only available for couples in accordance with present artificial reproduction technique regulations, there are single women are willing to deliver children via artificial reproduction technique. Therefore, the artificial reproduction technique is no longer a medical behavior only for sterility but also become a consumer behavior taking advantage of medical technology due to issues brought by social development and reputation to women’s right of reproductive autonomy. Whether the consumer protection law shall be applied is also an issue of concern. Furthermore, the “Pilot Plan for Medical Service Internationalization” passed by Executive Yuan in July 2007 opened “Five Major Competitive” medical services with international competitive advantages available for people in Mainland China, including artificial reproduction technique. It is thus clear that issues regarding artificial reproduction technique involved with people from China may occur in the future. Therefore, the study of rights and obligations regarding artificial reproduction technique is very important. Although the artificial reproduction agreement is a medical agreement, it is different from general medical agreement due to its distinct nature. In addition, the legal issues between hospital and patient could not be settled completely because there is no applicable regulation or laws clarified due to unfamiliar with artificial reproduction technique. Therefore, the study aims at the liabilities regarding artificial reproduction agreement to provide related suggestions. It is expected that the study may help clarifying the content, nature and relationship among the Parties of artificial reproduction agreement, meanwhile people in medical industry may understand more about the legal responsibilities in regard of artificial reproduction agreement and exercise due care. I also hope that people accepting artificial reproduction technique know well their rights and cooperate with medical providers to create beautiful lives altogether. The difficulties of handling medical accidents are usually because people are not familiar with medical behaviors and therefore it is hard to apply them to regulations or theory of laws. Thus, understanding the special nature of medical behaviors is actually the first step for study of medical agreement. The study first introduces the meaning, features and procedures of artificial reproduction in chapter two. For disputes arising from designation, contract, employment or anonymous agreement in regard of the nature of medical agreement, the study discussed and provided opinions aiming at nature of artificial reproduction agreement in chapter three. |