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醫療專欄

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高雄律師-楊岡儒律師【醫療法專欄(25)】醫療訴訟與整形美容(8):整形美容之民事損害賠償責任(1) Mrs Penny Johnson VS Mr Le Roux Fourie之案例分析(3)


 

2011.8.20 高雄律師-楊岡儒律師

 

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相關新聞與文章請參閱:


 

【兔寶寶醫療新聞(12)換臉失敗英國婦女獲賠近千萬美元

 

 

 

【醫療法專欄(23)醫療訴訟與整形美容(6):整形美容之民事損害賠償責任(1) Mrs Penny Johnson VS Mr Le Roux Fourie之案例分析(1)

 

 

 

【醫療法專欄(24)醫療訴訟與整形美容(7):整形美容之民事損害賠償責任(1) Mrs Penny Johnson VS Mr Le Roux Fourie之案例分析(2)

 

 


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上次主要在說明『壹、案例基礎事實與初步醫療責任分析』,

 

接下來,我們要談論損害賠償之計算初步基準。

 

 

 

貳、損害賠償之計算初步基準:損害(傷害)初步評估

 

當事人原告 強森 女士(Penny Johnson)因為該整容手術之失敗,除應審酌本件並『非傳統基於疾病治療之必要性醫療行為』,並應考量其失能及損害狀況。

 

 

 

準此而言,其因手術肇致之『永久性損壞(It caused Permanent Damage)』、『自發性異常之面部活動(Resulting in an Abnormal Spontaneous Facial Movement)』(註:顏面神經失調症狀)及促使原告產生心因性焦慮與抑鬱症狀等。即屬本件損害(傷害)初步評估判定之範圍。茲分析如下:

 

 

 

一、物理性傷害與心因性損害:

 

本判決中提及:「心因性(心理性)影響之傷害(The Psychological Impact has been Profound)」,除物理上之傷害之外(The Physical Injury),主要在於評估「心因性(心理性)影響之層面與深遠程度Psychiatric Symptoms, or as to The Prognosis)」;因此,我們來觀察判決中所提到認知行為治療Cognitive-Behavior Theapy又稱為認知行為心理治療;簡稱CBT」之輔助判定內涵:

 

(註解:非藥物治療之「認知行為治療(CBT)」,勞請讀者自行查閱;)

 

(目前臨床醫學上,治療恐慌或憂鬱等病症,雖人主要係心因性病症,基本上仍或多或少會配合「藥物治療」。但是仍是個案而由專業醫師判定之。

 

 

 

They agree that a course of cognitive behavioural therapy (CBT) is indicated after the settlement of the claim, and that her depressive and anxiety symptoms should improve with the resolution of the claim and treatment. But they also agree that chronicity of symptoms generally reduces the response to psychological treatment, and that her response to treatment is likely to be limited if, as will be the case, the physical symptoms persist.

 

 

 

They acknowledge that it is probable that she will not fully recover her previous personality and that her loss of confidence will persist. As Professor Trimble puts it “… it is likely that with her view that she has been damaged, her depressive symptoms will remain for the foreseeable future.” They conclude their joint report in the following terms:

 

 

 

“The experts agree that the settlement of her claim and the provision of treatment should improve the claimant’s depressive and anxiety symptoms. However, loss of confidence is likely to persist and she is at risk of further depressive symptoms associated with stress.

 

 

 

The favourable prognostic factors are a previously well-adjusted personality and an absence of earlier psychiatric illness. The unfavourable factors are the duration of her condition, the impact of physical and psychological problemson her career and continuing facial symptoms.”

 

 

 

二、本件爭點(損害評估範圍):

 

謹然附上原判決爭點摘要如下,並分析於後:

 

The Issues

 

The principal issues between the parties are the assessment of general damages for pain suffering and loss of amenity, and secondly the claim for loss of earnings, both past and future. Each require a comparison of the claimant’s personality and abilitiespre and post the negligent surgery. It is therefore necessary first to consider her background and achievements up to August 2003.

 

 

 

(一)本件主要爭點及損害評估範圍,在於當事人間,涉及評估一般損害賠償範圍內涵,亦即應包含:「原告(被害人)所遭受之生理、心理痛苦與整容所遭致之損失(For Pain Suffering and Loss of Amenity)」。

 

 

 

(二)其請求或索賠之範圍,應涵攝「收入損失範疇」,其時點並應綜合評估「過去和未來」之整體時空(時間軸)。

 

 

 

(三)其各別之請求或索賠,仍須審酌原告之整體狀況,包含個性及能力(The Claimant’s Personality and Abilities含職業及收入)等,以及該過失整形手術前後之所造成之差異或影響等層面。

 

 

 

(四)準此,本判決認為上述之爭點,首先有必要審酌原告(被害人)之成長背景與成就,截自20038月止,作為初步評估基準。

 

(待續)

 

帝謙法律事務所官方網站   :http://www.dclaw.tw
高雄律師-楊岡儒律師網站1:http://www.lawfirm.com.tw
高雄律師-楊岡儒律師網站2:http://www.lawoffice.com.tw




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