民事給付賠償之精神鑑定

Forensic Psychiatric Evaluations for Civil Compensation

10.29478/TJP.200712.0007

吳建芝(Chien-Tzu Wu)；劉絮愷(Shi-Kai Liu,)；謝明憲(Ming H. Hsieh)；陳俊霖(Chun-Lin Chen)

民事精神鑑定 ； 損害賠償 ； 賠償性官能症 ； 失能程度 ； forensic evaluation ； civil compensation ； compensation neurosis

台灣精神醫學

21卷4期（2007 / 12 / 01）

291 - 298

繁體中文

目的：了解民事司法精神鑑定給付賠償相關個案之特性，藉此探討法律與精神鑑定與給付賠償相關之議題。方法：回溯性檢視自民國50年至94年間－醫學中心司法精神鑑定中有關損害賠償案件案例之病歷、鑑定報告、法院卷宗，以呈現其醫學與法律各面向之議題，並藉此探討法律與醫學概念之交錯。結果：損害賠償案件共計30件。腦傷（25例）為最常見之身體傷害；以精神傷害作為求償之標的者有3例。法院主要詢問個案之精神狀態與預後，亦有少數要求鑑定因果關係。個案之臨床表現及鑑定時之特點，因其傷害之性質各有其特定類型。結論：損害賠償案件之精神鑑定中，個案精神狀態與事件間之因果關係往往難以斷定，尤其法律對因果關係之認定與醫學概念不盡相同。鑑定人除著眼於醫學或精神醫學之診斷，亦需注意法律程序本身及其他社會心理因素對個案精神狀態之影響，而於鑑定報告中明確描述臨床觀點，期能協助法官界定責任歸屬之問題。而以精神症狀為求償標的時，責任歸屬、事件與傷害之本質、法律訴訟過程之影響等非醫療性因素之影響益形重要。鑑定人宜力求清楚釐清臨床症狀之發展過程及其複雜成因，促進法界與醫界對其觀念不同之處溝通以達成共識。

Objective: The current study explored the characteristics of civil compensation cases referred for forensic evaluations, focusing on related legal and medical issues. Methods: Cases receiving forensic evaluation for civil compensation at the National Taiwan University Hospital from 1961 to 2005 were reviewed retrospectively. A classification based on the nature and consequences of the injuries with related assessment issues was attempted and summaries of typical cases were provided to illustrate distinct features of individual categories. Results: Thirty out of a total of 34 I civil forensic cases were compensation cases. Among them, brain injuries were the most common type of injury (25). Three cases claimed psychic injuries. The courts were most concerned with the sequelae of the injuries, including the prognosis, degree of decrements in occupational capacity, and severity of disability. The courts inquired about the causal relationship between the accidents and clinical manifestations in only 9 cases. Conclusion: In psychiatric evaluation for civil compensation, the causal relationship between the accidents and the subject's mental status should take into consideration the issue of liability, the nature of the injury, and the impact of legal processes. Psychic injury as the target of claim posed substantial difficulties for the determination of causation and level of disability.

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