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人體試驗民事責任之研究―以新藥臨床試驗為主題 / Study of Civil Liability on Human Subjects Research ― Focus on Drug Clinical Trial丁予安 Unknown Date (has links)
近年來,病人自主權意識高漲,醫療糾紛頻傳,每個醫師無不戒慎恐懼,而醫療爭議之處理模式與醫師專門職業之道德責任都受到社會高度的檢視及廣泛的討論。事實上,醫學的進步需要依賴不斷地創新與大膽地試驗研究,因此人體試驗相關的問題也受到大眾的關注。
由於人體試驗所面對的是複雜而變化多端的情境,所以參與人體試驗之受試者將會面對甚而遭到危險或傷害。我國人體試驗的相關法規,多散置於醫療法、醫師法、藥事法、藥品優良臨床試驗準則、藥品優良臨床試驗規範等,除了無整體之法規範外,且多為行政法令,在法律位階上均較低,加上衛生署主管機關無法落實對試驗過程中之管理與監控,因此參與人體試驗之受試者往往會受到損害而無法得到應有的保障。因為人體試驗的特殊性與常規醫療是不同的,如果僅由既有的傳統醫療糾紛處理方式,如醫療契約於受試者的關係、侵權行為於違反保護他人法律的標準、醫療倫理不傷害原則於人體試驗規範等,這些恐怕都是必須的,但是仍嫌不足。
本文參考國外人體試驗規範包括紐倫堡法則、赫爾辛基宣言、美國貝爾蒙特報告、美國聯邦法規、CIOMS國際生物醫學研究人體試驗倫理準則、國際醫藥法規協和會之優良人體臨床試驗準則等等,然後針對個別議題如受試者保護之告知後同意,受試者權益之醫療契約關係及侵權行為責任,受試者受傷害之損害賠償責任,作一整理分析與檢討,並進一步配合我國現行法律制度與社會倫理規範做出建議。
本文共分為七章,分別為「序論」、「人體試驗」、「人體試驗告知後同意法則」、「國外人體試驗之民事責任」、「我國人體試驗之民事責任」、「人體試驗之賠償責任及機制」及「結論」。 / In recent years, patients’ consciousness of self-determination has raised and many medical disputes occurred; doctors feel discomfort and developed the high intensity of self-defense. The solution of medical malpractice and professional liability of doctors have became the major public issues and received many discussions. We are quite sure that the medical progress is based on innovative and intensive clinical study on human subjects. Under this background, the topics on human subject research have been attracted more attention than ever.
Since the situations in human research are complex and variable. If relative clinical standards and legal protections are not adequately provided, the human subjects involved in clinical researches may face many risks and even injured. In Taiwan, we don’t have a systemic regulations on human subject research, all regulations are distributed in different code, act, proceeding, and agreement. Furthermore, the government does not have enough resource and manpower to monitor or inspect the processes of human research, the issues of protection of human rights and benefits of testee has raised serious concern. The human subject research is not exactly the same as the clinical medical treatment, it’s impossible for legislators or institutions to regulate research through traditional medical regulations such as medical ethics doctor-involved informed consent, medical agreement (contract), tort laws, and compensation for injury.
In this thesis, firstly, I reviewed the most important publications related to human subject research include Nuremberg Code, Declaration of Helsinki, USA’s Belmont Report and Code of Federal Regulations, CIOMS International Ethical Guidelines for Biomedical Research Involving Human Subjects, and ICH-GCP; secondly, focus on each specific topics especially the value of informed consent, the importance of medical agreement, the liabilities of torts and the policy of compensation for injury. Finally, I’ll make my comments and suggestions to the health care authorities to update and implement new regulating policies to protect human rights of subjects involved in clinical researches.
My thesis is restricted to discuss the impact of civil liability on human subjects research focus on drug clinical trial and divided into seven chapters as follows: “Introduction”, “Human subject research”, “Principles of informed consent”, “International liability of civil law on human subject research”, “Liability of Taiwan civil law on human subject research”, “Policy of compensation for injured human research subject” and “Conclusion”.
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