Astract The purpose of the research aims at exlporing the relationship of organizational ethical climate, the principles of medical ethic and the performances of medical behavior and hope to get some findings that will benefit the managers and decresae the medical disputes. The major findings are summarized as follows: 1. The more health care workers pay attention to the principles of medical ethic of nonmaleficence¡Bautonomy and beneficence, the better the performances of medical behavior are. 2. The more health care workers emphasize the importance of the principle of medical ethic of justice, the less the breakout of injustice. 3. The more hospitals put emphasis on the importance of climates of law and code¡Bcaring¡Brules, the better the performances of medical behavior are 4. While Instrumental climate is obvious, the outbreak of the injustice is easier. 5. Compared with others technicians, administrants, and nutritionists, doctors and nurses feel less the climate of caring. 6. The higher the climates of law and code¡Brules that hospital managers conducted are, the lower the climates of caring and instrumental are. 7. Those who are seniors show the climates of law and code¡Brules more, while those who are older also show the climate of the rules.. 8. The invasion of autonomy in the climate of performances of medical behavior is the most serious. 9. Those health care workers with a bachelor¡¦s degree feel less the climate of law and code.

近年來有關醫療法律糾紛案件有逐漸增加之趨勢，本文嘗試藉由實證分析，剖析目前實務與學理上之不同見解，簡要提出個人淺見。於實證分析前，本論文先就文獻理論作簡略之論述，首要說明醫療行為與醫療糾紛之相關概念，以界定醫師或醫療機構對其醫療行為應負之責任。並從實體法上論述醫療過失民事責任之基礎及其內涵，如醫療契約責任、醫療侵權責任、消保法與醫療法之適用，以及醫療過失之因果關係等。次就程序法上探討民事醫療訴訟舉證責任分配之基本原則，同時就美國法與德國法有關醫療過失舉證責任分配的調整於我國實務上之運用，作概略分析及探討。再者，鑑於法官於具體個案中判斷醫療糾紛之相關要件，往往需將訴訟資料送請醫療專業機構加以鑑定，因此，本文亦加以說明我國醫療鑑定制度運作之現況，並據此指出現行醫療糾紛鑑定問題之所在。 最後，本文就最高法院民事案件，分別從醫療糾紛判決背景資料之「年度」、「醫療機構層級」、「科別」、「上訴人」與「上訴結果」，以及醫療糾紛審判實務，如「醫療過失」、「因果關係的認定」、「民事責任請求權基礎及舉證責任之分配情況」、「告知義務」、「醫療鑑定在醫療糾紛應用」，進行實證分析，並依實證數據成果，提出「醫療科別屬性與醫療糾紛案件量多寡密切攸關」、「法院對於醫師在個案是否盡注意義務，應以理性醫師之注意標準綜合評價」、「針對醫療訴訟特性，適度分配醫病雙方之舉證責任」、「宜建立醫療傷害補償基金制度」、「醫事人員確切履行告知說明義務」、「健全現行病歷表之相關問題」、「關於醫療糾紛鑑定實務」暨「透過消保法填補醫療（院）組織疏失之責任」等八項結論及建議，以供實務與學術研究者未來對於醫療糾紛訴訟案件研析時之參考。 / Recently, legal cases concerning medical dispute have a tendency to increase gradually. This article tries to explore different viewpoints between practice and academic theory by empirical analysis and then briefly indicates some of my humble views. Before doing the empirical analysis, this article will briefly introduce the related literatures and theories. Firstly, explains related concepts between medical behavior and medical dispute to define the liability that doctor and medical institution should bear because of their medical behaviors. Then, discuss the basis and connotation of the civil liability for medical malpractice from the substantive law viewpoint, such as the liability for medical contract, medical tort liability, the implementation of the Consumer Protection Law and the Medical Care Act and the causality from the medical malpractice etc. Secondly, this article will discuss the basic principles of allocation of burden of proof for civil medical dispute from the procedural law viewpoint and in the same time, briefly analyze and research that whether it is appropriate to adopt the allocation of burden of proof for medical malpractice from American and German law in our own practice. Furthermore, respecting the fact that for judges to make their decisions in particular medical dispute cases, they always have to send action materials to professional medical institutes for identification, thus, this article also wants to explain the current situation of implementation of our medical identification system, and points out the problems of current medical dispute identification system accordingly. Lastly, this article will proceed empirical analysis according to the Year, Levels of the medical institutions, Divisions, Appellant, Result of Appeal from the background of the verdicts of the civil medical dispute cases awarded by the Supreme Court and according to the medical malpractice, the determination of the causality, the condition of basis of civil title of claiming and allocation of burden of proof, obligation of informing, medical identification in the medical dispute from the medical dispute trial practice. Base upon these results, this article indicates eight conclusions and suggestions for reference for the active participants and academic researchers in future medical dispute lawsuits: the attribution of the medical care division and the number of the medical dispute cases are closely related, court should do omnibus assessment using the standard of due diligence as a rational doctor to determine whether a doctor fulfill his duty of care in a specific case, with the particularity of medical actions in mind, appropriately allocate the burden of proof between doctor and patient, it is better to establish the compensation foundation system for medical damage, medical personnel should literally perform their obligation of informing, to refine the problems of current medical record, things concerning medical dispute identification practice and using the Consumer Protection Act to fill the vacancy that caused by the negligence of the medical institutions.