| IVOD_ID |
167330 |
| IVOD_URL |
https://ivod.ly.gov.tw/Play/Clip/1M/167330 |
| 日期 |
2026-01-29 |
| 會議資料.會議代碼 |
委員會-11-4-26-22 |
| 會議資料.會議代碼:str |
第11屆第4會期社會福利及衛生環境委員會第22次全體委員會議 |
| 會議資料.屆 |
11 |
| 會議資料.會期 |
4 |
| 會議資料.會次 |
22 |
| 會議資料.種類 |
委員會 |
| 會議資料.委員會代碼[0] |
26 |
| 會議資料.委員會代碼:str[0] |
社會福利及衛生環境委員會 |
| 會議資料.標題 |
第11屆第4會期社會福利及衛生環境委員會第22次全體委員會議 |
| 影片種類 |
Clip |
| 開始時間 |
2026-01-29T11:16:58+08:00 |
| 結束時間 |
2026-01-29T11:44:31+08:00 |
| 影片長度 |
00:27:33 |
| 支援功能[0] |
ai-transcript |
| video_url |
https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/58229044bac95a88c30e74f18ff838a152fd623850d83d5bef4d1ce49928203b332e030545e112f65ea18f28b6918d91.mp4/playlist.m3u8 |
| 委員名稱 |
林淑芬 |
| 委員發言時間 |
11:16:58 - 11:44:31 |
| 會議時間 |
2026-01-29T09:00:00+08:00 |
| 會議名稱 |
立法院第11屆第4會期社會福利及衛生環境委員會第22次全體委員會議（事由：邀請衛生福利部就「春節急診醫療人力調度與跨院協調機制之現況與精進作為」暨「假日及連續假期急重症分級醫療政策之執行成效與改進方向」進行專題報告，並備質詢。
討論事項
審查
一、 委員何欣純等17人擬具「國民年金法第五十四條之一及第五十五條條文修正草案」案。
二、 委員邱鎮軍等17人擬具「國民年金法第十五條及第五十四條之一條文修正草案」案。
三、 委員王美惠等18人擬具「國民年金法第五十四條之一條文修正草案」案。
四、 委員劉建國等16人擬具「國民年金法第五十四條之一條文修正草案」案。
五、 委員馬文君等20人擬具「國民年金法第五十四條之一條文修正草案」案。
六、 委員徐巧芯等18人擬具「國民年金法第五十四條之一條文修正草案」案。
七、 台灣民眾黨黨團擬具「國民年金法第五十四條之一條文修正草案」案。
八、 委員邱鎮軍等21人擬具「國民年金法第十五條及第五十條條文修正草案」案。
九、 委員陳俊宇等29人擬具「國民年金法第五十四條之一條文修正草案」案。
十、 台灣民眾黨黨團擬具「國民年金法第十五條及第五十條條文修正草案」案。
十一、 委員黃秀芳等21人擬具「國民年金法第五十四條之一條文修正草案」案。
十二、 委員羅廷瑋等16人擬具「國民年金法第五十四條之一條文修正草案」案。
十三、 民進黨黨團擬具「國民年金法部分條文修正草案」案。
十四、 委員蔡易餘等17人擬具「國民年金法部分條文修正草案」案。
十五、 委員吳思瑤等18人擬具「國民年金法部分條文修正草案」案。
十六、 委員郭國文等17人擬具「國民年金法第五十四條之一條文修正草案」案。
十七、 委員王美惠等22人擬具「國民年金法部分條文修正草案」案。
十八、 委員徐富癸等18人擬具「國民年金法第五十四條之一條文修正草案」案。
十九、 委員陳亭妃等16人擬具「國民年金法部分條文修正草案」案。
【專題報告與討論事項綜合詢答，討論事項僅詢答】） |
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謝謝主席 我們是不是請石部長 請石部長另外一人早 部長這個中榮的這個業務到底有沒有帶到 |
| transcript.whisperx[1].start |
19.477 |
| transcript.whisperx[1].end |
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到底有沒有抄刀你說要一個禮拜給大家報告早超過一個禮拜了這個以他送來的這個報告他送來的報告我們都知道是說沒有但他送來報告說沒有之後人家影像就曝光了所有的媒體都看過了人民也看過了就是有你現在還在講他送來的報告你知道你們醫師法 |
| transcript.whisperx[2].start |
47.313 |
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66.244 |
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怎麼規範密醫行為6個月以上5年以下嘛對不對可是醫生有什麼責任你們的醫師法如果醫師法28條之4聘僱容留密醫去執行這個手術你們28條之4對醫師怎麼處罰有刑責嗎 你先回答我有沒有刑責 |
| transcript.whisperx[3].start |
76.583 |
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87.105 |
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龍柳啊龍柳跟聘顧密醫來幫我做手術這個醫師有沒有刑責龍柳的部分沒有啦聘顧有沒有聘顧龍柳龍柳跟聘顧通通都沒有你們的醫師去找一個密醫來幫他帶刀只有罰10萬到50萬你覺得這個機制這樣子 |
| transcript.whisperx[4].start |
105.339 |
| transcript.whisperx[4].end |
119.745 |
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公平嗎那個密醫是有刑責但是聘僱密醫的人的醫師沒有刑責罰十萬元可以了事這樣醫生敢去請密醫來操刀嗎 大家也敢 |
| transcript.whisperx[5].start |
124.087 |
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126.069 |
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你覺得這種法律的設計有公平嗎沒有公平 太檢討沒有公平嘛 第一 你知道 我跟你說過嘛在開刀房裡面 醫師 護理師 麻醉科醫師 大家都參與其中 |
| transcript.whisperx[6].start |
144.364 |
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170.112 |
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病人可以告他們加重詐欺是不能緩刑的非關不可的喔但是檢舉的人自己就有刑責不能緩刑的不能一顆罰金的加重詐欺喔我說過嘛但是我要問你崔少哲保護法能不能保護讓這個崔少哲揭弊的人可以免除刑責可不可以 |
| transcript.whisperx[7].start |
173.117 |
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179.96 |
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你不知道好我先問你吹哨者保護的揭弊的對象限於什麼資格他揭弊的範圍 |
| transcript.whisperx[8].start |
183.942 |
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208.995 |
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不涉及私人企業啦你懂嗎所以只有公部門的醫院公立醫院的接避者可以讓這個吹哨者保護法去協助給他網住接住現在我問你公立醫院占整體醫院幾個百分比我們的大概是20個百分比 |
| transcript.whisperx[9].start |
210.208 |
| transcript.whisperx[9].end |
224.506 |
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所以有八成 八成的醫院而且私立醫院才是這種讓業務操刀的可能問題更多私立醫院的接避者是得不到接避者保護的 |
| transcript.whisperx[10].start |
226.178 |
| transcript.whisperx[10].end |
237.567 |
| transcript.whisperx[10].text |
所以他們怎麼接避 你說三個手段嘛你的三個手段就是組一個調查小組第二個訂一個手術室指引第三個請醫策會積極輔導這個東西有辦法 |
| transcript.whisperx[11].start |
243.522 |
| transcript.whisperx[11].end |
268.215 |
| transcript.whisperx[11].text |
解決這個問題嗎 有限 有限啦 沒錯我現在要跟你說 我再跟你講一次 接避者保護的這一個機制對私立醫院的接避者來講很重要 你說要怎麼處理這個事情沒有比接避出來接避免除刑責的這一個保護機制更重要的 好 |
| transcript.whisperx[12].start |
271.236 |
| transcript.whisperx[12].end |
282.761 |
| transcript.whisperx[12].text |
醫師罰28條之4醫師去聘僱一個密醫來操刀沒有刑者只有罰10萬這個事情你應該去討論一下那我現在一併要跟你討論的是 |
| transcript.whisperx[13].start |
285.253 |
| transcript.whisperx[13].end |
289.775 |
| transcript.whisperx[13].text |
我們希望你藉著這次事件一併修正改進我下面要講的這一個議題這個議題就是說啊你們劉月餅市長在這,我先抱怨一下他說你們就根據中榮的報告,業態沒有操刀然後劉市長你說啊醫學院畢業大家都資優生畢業的醫生給他們寄生借就很可惜,不可能 |
| transcript.whisperx[14].start |
314.89 |
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327.883 |
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不可能會這樣做啦那個劉市長天兵啊厲害啦但我現在不是要講這個啦現在教學醫院當中除了主治醫師通常還會有 |
| transcript.whisperx[15].start |
329.472 |
| transcript.whisperx[15].end |
350.208 |
| transcript.whisperx[15].text |
醫院的門診除了主治醫師有時候就是住院醫師、實習醫生或是PGY因為是教學醫院但他們這些教學醫院的門診在主治醫師的指導下他會進行病史詢問病理學的檢查那病人可以自由選擇是不是要接受教學服務 |
| transcript.whisperx[16].start |
351.69 |
| transcript.whisperx[16].end |
363.484 |
| transcript.whisperx[16].text |
他可以自由選擇要不要有其他醫師在場他可以告訴這個主治醫師嘛他有執行權因為他沒有被麻醉嘛他意識清楚嘛所以他可以選擇權他說我 |
| transcript.whisperx[17].start |
367.168 |
| transcript.whisperx[17].end |
388.74 |
| transcript.whisperx[17].text |
我這個不想要但是也有很多醫師大牌的醫師在門診的時候掛號的時候就已經揭露了本診為教學門診診療時會有住院醫師實習醫師跟診學習如果你不方便我就是一定要教你不方便你不要來看這一診這也是一個方法 |
| transcript.whisperx[18].start |
390.001 |
| transcript.whisperx[18].end |
416.876 |
| transcript.whisperx[18].text |
但是呢我要講的這狀況很容易監督啊因為病人意識清楚啊有資訊告知啊有執行權啊病人也有選擇權啊隨便你要不要我就是要教學也在教學當中我們的醫療技術也在進步也是靠這個也是要純誠啊當然是要靠這樣子進步但是我要問你是教學手術呢 |
| transcript.whisperx[19].start |
417.896 |
| transcript.whisperx[19].end |
422.028 |
| transcript.whisperx[19].text |
教學手術保證到自己的知情權和選擇權 |
| transcript.whisperx[20].start |
425.782 |
| transcript.whisperx[20].end |
451.584 |
| transcript.whisperx[20].text |
教學手術就是手術當中有有實習醫師或者是學生在旁邊對啊他是教學型的手術操作我想這個手術過程當中也是一個在醫學生學習或者是這個住院醫師也好實習醫師也好對啦我現在講的是有沒有知情權有沒有讓這個因為被麻醉躺在那裡啊誰進來手術事實上不知道啦那我的意思是說 |
| transcript.whisperx[21].start |
452.745 |
| transcript.whisperx[21].end |
459.41 |
| transcript.whisperx[21].text |
你們現在的這個設計步驟程序有沒有讓被手術的人知情有沒有可做選擇的選擇權就像門診你都這麼縝密了連門診大家都這麼做了那操刀的風險是更大的那操刀的程序裡面教學型的手術操作這個受術者有沒有這一些規範 |
| transcript.whisperx[22].start |
484.529 |
| transcript.whisperx[22].end |
507.181 |
| transcript.whisperx[22].text |
這個兩個層面第一個就是說過去我們有訂了這個教學的指引裡面把這些倫理規範要求進去那麼住院的部分跟這個手術的部分我們來檢討一下剛剛有沒有需要去擴充之前的那個門診我們現在不是在講倫理規範我們現在講的就是制式規定世代已經走到現在來了 |
| transcript.whisperx[23].start |
510.583 |
| transcript.whisperx[23].end |
533.841 |
| transcript.whisperx[23].text |
為什麼要講呢 教學手術除了 大家知道沒有告知這個病人 因為手術要填寫一個同意書嘛你們自恃的手術同意書的內容就是疾病名稱 建議手術名稱 建議手術的原因醫師的聲明 手術負責醫師的姓名專科別簽名 病人聲明 立同意書人姓名病人的關係人簽名 |
| transcript.whisperx[24].start |
536.384 |
| transcript.whisperx[24].end |
553.619 |
| transcript.whisperx[24].text |
門診是意識清醒的 但手術的受術者是意識不清醒的所以其實是只有填寫這一個手術同意書是不夠的2021年張基的院長陳木寬大家都知道瘋者的風風雨雨 |
| transcript.whisperx[25].start |
555.907 |
| transcript.whisperx[25].end |
583.76 |
| transcript.whisperx[25].text |
則募官遭多名離職的醫護人員指控偽造開刀房的記錄 詐領保險費 涉及不法還批報他一天就排17刀 而人在台北開會髒話還有掛名的手術在進行不僅如此 還有離職的醫師爆料說一天三四十刀都是常態 |
| transcript.whisperx[26].start |
585.782 |
| transcript.whisperx[26].end |
604.902 |
| transcript.whisperx[26].text |
醫生遭到霸凌離職了就這樣子檢舉然後醫院說前置後續作業可由醫療團隊執行主導醫師可以到另外一間手術進行手術關鍵部分然後所以那個張基就出了一個聲明 |
| transcript.whisperx[27].start |
605.643 |
| transcript.whisperx[27].end |
632.59 |
| transcript.whisperx[27].text |
他說手術參與的醫師有團隊總醫師住院醫師主刀醫師組織醫師以上繁雜卻必要的程序不可能由主刀醫師一人完成由醫療團隊們進行關鍵步驟之外的前置與後續在此同時主刀醫師便可以到另外一間手術為另外一個病人進行手術關鍵的部分好他講的原則我們都同意但真正的是這一個 |
| transcript.whisperx[28].start |
633.65 |
| transcript.whisperx[28].end |
660.693 |
| transcript.whisperx[28].text |
院長當天到底是不是這樣子 那可就不一定啦他們的聲明講的我們都同意但真正操作的是不是如聲明所講的 不知道餒 像一天三四十刀像生產線一樣麻醉之前露個臉 下面之後是誰開的 不知道欸所以我常常說這是一個模糊的地帶 |
| transcript.whisperx[29].start |
663.084 |
| transcript.whisperx[29].end |
678.576 |
| transcript.whisperx[29].text |
那有沒有需要再更精緻的規範啊手術當中到底有幾個醫師動刀病人在上手術台以前有沒有基本的知情權啊部長手術教學的風險會不會高手術的風險總是高於門診的風險 教學嘛 |
| transcript.whisperx[30].start |
690.246 |
| transcript.whisperx[30].end |
702.819 |
| transcript.whisperx[30].text |
那病人的安全保障應該比看門診的時候還更嚴謹啊他的知情權也應該要更獲得保障啊那他要不要有選擇權也應該要有啊所以在這種狀況你覺得呢 |
| transcript.whisperx[31].start |
708.454 |
| transcript.whisperx[31].end |
731.213 |
| transcript.whisperx[31].text |
跟委員說明以現在來講我們剛剛提到的三個層次第一個過去已經在門診需要有告知知情的部分我們來研議把它納入那特別是學生的部分大概都OK因為意識清醒也沒有辦法變住院跟手術的部分我們來研修這是第一個第二個 |
| transcript.whisperx[32].start |
732.014 |
| transcript.whisperx[32].end |
751.459 |
| transcript.whisperx[32].text |
有所謂的接刀或跨刀的情形是確實會有有這個需要那但是我們也把它訂出一個原則出來那第三個呢那實務上呢可以透過我們健保的申報可以了解它的合理性我們去勾結一下那些高量當初這個案件來市長你當市長了嗎當初張基這個案件 |
| transcript.whisperx[33].start |
755.144 |
| transcript.whisperx[33].end |
760.866 |
| transcript.whisperx[33].text |
狀況怎麼樣好你提供給我一個調查報告沒關係好來我現在再問一下就曾經有一個離譜的案件安裝心臟支架的手術組織醫師是為了訓練住院醫師這個我覺得是一定要這樣子嘛教學嘛教學相長然後大家都一定要這樣子來學習嘛 |
| transcript.whisperx[34].start |
777.651 |
| transcript.whisperx[34].end |
793.825 |
| transcript.whisperx[34].text |
但是他在訓練的過程裡面在沒有告知病人的狀況裡面放手讓這個住院醫師去指導結果發生安裝的疏失了最後主治醫師推卸責任推卸給住院醫師 |
| transcript.whisperx[35].start |
795.827 |
| transcript.whisperx[35].end |
814.018 |
| transcript.whisperx[35].text |
結果家屬自始至終的蒙在鼓裡根本不知道這台攸關性命的手術除了主治醫師之外還有住院醫師也參與執刀所以這大家覺得說你隱瞞病人術後推諉因為發生事情了才講說這不是我來住院 |
| transcript.whisperx[36].start |
815.149 |
| transcript.whisperx[36].end |
843.394 |
| transcript.whisperx[36].text |
在這種狀況這責任的確是責任在你們現行的規範裡面責任屬誰你告訴我主治醫師啦這個醫病關係的建立是在主治醫師啦我說法律責任法律責任也是啊因為在這裡面是你授權嘛你授權那你在這裡面破壞了病患對你主治醫師的信任以外但病患都不知道操刀的是住院但是我們如果沒有這一個過程你怎麼訓練 |
| transcript.whisperx[37].start |
844.966 |
| transcript.whisperx[37].end |
868.061 |
| transcript.whisperx[37].text |
住院醫師呢 那這個責任要怎麼決定因為沒事情就沒事情嘛 有事情要怎麼辦我出門問你 你說你瘦了這樣沒人要做主 沒人要做教學生 沒人要做主治醫師要怎麼辦責任很清楚 因為這個醫病關係的建立是在主治醫師所以這個責任是很清楚 但是這一些情形為了 |
| transcript.whisperx[38].start |
869.002 |
| transcript.whisperx[38].end |
884.519 |
| transcript.whisperx[38].text |
我們不是也通過了一個醫療事故預防及正義處理法其實就是要解決像這一類的事情他並不是故意所為但是就有這樣的發生你完全把責任歸咎於他但我的意思是說責任上是這樣沒有錯那現在病人 |
| transcript.whisperx[39].start |
888.563 |
| transcript.whisperx[39].end |
907.16 |
| transcript.whisperx[39].text |
他是第一線的第一線直接就如果有疏失當然不是故意你免刑者沒關係但是他是第一線就是受害的那他這種病人難道不應該有知情權在事前要知情 要同意吧 |
| transcript.whisperx[40].start |
908.052 |
| transcript.whisperx[40].end |
936.263 |
| transcript.whisperx[40].text |
所以知情很重要知情而且要取得他同意吧如果沒有的話會不會很糟糕這個在倫理上也是需要啦知情一定需要啦那事後的告知也是需要我們在那個醫療事故預防性正義處理就有談到這個事後發生的事情也要告知嘛我現在跟你說那要不要事前同意事前也要啊對不對現在有這種知情和同意權嗎現在 |
| transcript.whisperx[41].start |
938.457 |
| transcript.whisperx[41].end |
951.402 |
| transcript.whisperx[41].text |
我們來規範你們現在沒有啦所以我們現在手術同意書的規範不足是否為教學手術參與動刀的醫師有誰我們都要透明嘛 |
| transcript.whisperx[42].start |
955.723 |
| transcript.whisperx[42].end |
975.643 |
| transcript.whisperx[42].text |
那是否涉及新進的技術或設備要不要告知我應該是講的是說在這個手術同意書上要不要擴充到包含手術的團隊那麼中間有沒有涉及到你如果是教學型的有住院醫師有誰要來可能會涉及到 |
| transcript.whisperx[43].start |
976.664 |
| transcript.whisperx[43].end |
994.248 |
| transcript.whisperx[43].text |
Involve到裡面要教學啊那要不要告知那涉及到新進的技術或設備要不要告知新進的技術或設備要不要告知這個告知要到什麼程度我們來研議的對 所以我現在在講就是說 |
| transcript.whisperx[44].start |
1000.993 |
| transcript.whisperx[44].end |
1020.492 |
| transcript.whisperx[44].text |
整個中榮的案件的核心不是只有業帶是不是進入手術室其實更核心是我們國家對於新進的醫療技術跟設備是否已經有清楚的規範到操作的資格和訓練的門檻 |
| transcript.whisperx[45].start |
1023.103 |
| transcript.whisperx[45].end |
1027.488 |
| transcript.whisperx[45].text |
你都一直說 業代比他更容易做啊 醫生不要 業代要來幫忙協助啊但我就從這裡來問你們 這樣子的問題 難道你們都不用去規範新進的技術越來越多 與時俱進 |
| transcript.whisperx[46].start |
1042.805 |
| transcript.whisperx[46].end |
1067.372 |
| transcript.whisperx[46].text |
新進的醫材設備這麼多與時俱進那你不用去規範每一種新的進來食藥署如果核准了一種了那你的訓練門檻要不要規範要不要現在有沒有規範我們在特管辦法就是醫療法的授權辦法有個特管辦法裡面有一些特定的技術是有規範的它就有一些門檻 |
| transcript.whisperx[47].start |
1068.973 |
| transcript.whisperx[47].end |
1093.229 |
| transcript.whisperx[47].text |
像新的像Proton新導管的不是一般的新導管有一些新的那種會刮除的那種的新導管速適風險比較高的高的他有規範在裡面什麼資格那像達文西手術也是一樣他一定要受過幾台的跟刀訓練之後他才能夠獨立操作才能取得執行的資格那每個都已經規範完整了嗎但是沒有辦法 |
| transcript.whisperx[48].start |
1094.251 |
| transcript.whisperx[48].end |
1098.968 |
| transcript.whisperx[48].text |
規範完整了嗎不可能完全啦所以我們隨時就調整就調整這樣 |
| transcript.whisperx[49].start |
1100.587 |
| transcript.whisperx[49].end |
1129.168 |
| transcript.whisperx[49].text |
對 所以有人講說你對於這個病人安全始終是醫療行為的首要考量你曾經這樣講嗎醫生面對新興的醫療技術必須接受完整的訓練醫生在過去的訓練當中可能會碰到新的技術或設備你曾經說例如達文西手術系統在他還是醫師訓練的階段可能沒有接觸過但在未來醫師要操作這類設備當然必須要接受訓練那你也說過 |
| transcript.whisperx[50].start |
1130.129 |
| transcript.whisperx[50].end |
1148.164 |
| transcript.whisperx[50].text |
病人安全才是最重要的醫療人員至少不能傷害病人所以訓練訓練絕對是必要的所以你講了兩種嘛第一種第一種訓練是模擬訓練嘛那像達文西手術系統就有模擬機可以讓醫師在模擬環境當中學習操作 |
| transcript.whisperx[51].start |
1148.965 |
| transcript.whisperx[51].end |
1156.769 |
| transcript.whisperx[51].text |
第二種是實務訓練許多國外的做法是讓受訓醫師由有經驗的醫院具備經驗的醫師帶領一下學習也不是交給業務代表來教導不是 |
| transcript.whisperx[52].start |
1164.913 |
| transcript.whisperx[52].end |
1193.612 |
| transcript.whisperx[52].text |
可是你知道現在很多醫院喔你到醫院去陸陸續續都會看到號稱全國第一套某種儀器設備全國第一套經常那這些醫院在引進新興的醫療設備發布新聞稿說哎呀我們今天終於幾月順利完成裝機再幾月要開始實施手術經常常常上一個月完成裝機下個月就要做 |
| transcript.whisperx[53].start |
1194.454 |
| transcript.whisperx[53].end |
1194.474 |
| transcript.whisperx[53].text |
少數 |
| transcript.whisperx[54].start |
1195.666 |
| transcript.whisperx[54].end |
1224.585 |
| transcript.whisperx[54].text |
那用這個當廣告那作為提升醫療服務造福病人的主要宣傳和訴求但是作為病患和家屬我們希望的新設備不僅是要快我們希望的是操作的人操作的能力操作的專業要完善和安全可是你們的特管辦法裡面沒有辦法更改的速度沒辦法改這麼快 |
| transcript.whisperx[55].start |
1225.926 |
| transcript.whisperx[55].end |
1246.884 |
| transcript.whisperx[55].text |
新的醫材設備發展的速度比你的法律還快啊那怎麼辦 這些高階的儀器設備你們沒有辦法 現行的法規沒有辦法發展的那麼快那你們要求實際操作人員需要具備合格的證明也來不及要求 這樣要怎麼辦 |
| transcript.whisperx[56].start |
1249.234 |
| transcript.whisperx[56].end |
1273.434 |
| transcript.whisperx[56].text |
這個我們來研究一下就是更新不急的問題啦可能要從源頭啦因為這些比較侵入性比較侵犯性的都是從FDA就許可所以我們要從前端開始如果他這個在查驗登記的時候要許可的時候那麼這個就是屬於有高門檻的就應該要直接寫進他的訪單裡面 |
| transcript.whisperx[57].start |
1275.015 |
| transcript.whisperx[57].end |
1298.851 |
| transcript.whisperx[57].text |
就是要求你要受過什麼訓練才能夠操作這台儀器的我們過去在醫財部等位他會這麼清楚就知道風險是什麼嗎所以未來我們要建立這個技術我們來檢討從源頭開始所以你的實際操作人員操作這種儀器要不要定合格操作的合格門檻最低訓練時數標準化的訓練程序達到門檻之後才能夠執行相關手術要把 |
| transcript.whisperx[58].start |
1304.875 |
| transcript.whisperx[58].end |
1324.883 |
| transcript.whisperx[58].text |
所以簡單的講就是說未來我們在審查這一類的比較侵犯性或者是很新的高科技的東西不是只有在審查文件還要去詢問這個專業醫學會的意見能夠操作這個的是不是要有一些人員的限制那現在有這樣子跑嗎還沒有 還沒有現在都沒有嗎對 我們來檢查所以現在實務上就是業務人員在教學 |
| transcript.whisperx[59].start |
1333.43 |
| transcript.whisperx[59].end |
1353.182 |
| transcript.whisperx[59].text |
所以你們是現在交給廠商在教學你剛才講到一個重點我們的醫學會難道是擺著放著而已嗎所以現在你們交給廠商會發生什麼問題有媒體報導指出部分醫生對於設備組裝流程不熟悉實際操作時一旦發生問題緊急聯絡的是 |
| transcript.whisperx[60].start |
1357.164 |
| transcript.whisperx[60].end |
1370.991 |
| transcript.whisperx[60].text |
廠商業務人員到廠所以在這種狀況裡面我想作為主管機關保證你感覺說目前這樣是沒合理的吧也不符合醫療安全要求的常態作業吧現在是這樣喔這樣你要多久的時間要改進 |
| transcript.whisperx[61].start |
1373.672 |
| transcript.whisperx[61].end |
1389.898 |
| transcript.whisperx[61].text |
我們把這個這一套制度我們把它研究要研究多久三個月我們希望這些新進的醫療技術和儀器設備的合作合格的操作標準訂出最低的訓練時數這個可以交給醫學會啊我們業必歸會要幹嘛 |
| transcript.whisperx[62].start |
1394.72 |
| transcript.whisperx[62].end |
1414.504 |
| transcript.whisperx[62].text |
業必歸會讓他們業會裡面可以他們自己對會員有這個自律去管理嘛所以不是交給業代那你知道婦產科內市競技微創醫學會他們規範的婦科機器手臂協助下微創手術醫師資格認證婦產科這個就訂的很詳細喔他說 |
| transcript.whisperx[63].start |
1419.325 |
| transcript.whisperx[63].end |
1445.491 |
| transcript.whisperx[63].text |
必須是台灣婦產科醫學會認證的婦產科專科醫師才能夠執行第二個至少要執行20例的婦科手術含開腹或及腹腔鏡手術其中腹腔鏡手術需要占10例以上並需要有主刀者手術紀錄第三參與本學會舉辦或本學會認可的機械手臂輔助婦科手術相關課程8小時 |
| transcript.whisperx[64].start |
1447.932 |
| transcript.whisperx[64].end |
1460.118 |
| transcript.whisperx[64].text |
第四 機械手臂操作要12個小時 含模擬機和實機操作保長你也稍微聽一下我聽你說婦產科醫學會在規定有有很多啦 包括你必須至少參與一台的動物實驗 擬真組織大體或AI模擬訓練以及至少一台的機械手臂輔助婦科手術觀摩或擔任助手經驗或是 |
| transcript.whisperx[65].start |
1475.265 |
| transcript.whisperx[65].end |
1481.155 |
| transcript.whisperx[65].text |
至少10台機械手臂輔助婦科手術觀摩或擔任住所經驗這兩項則依記錄就可以了然後 |
| transcript.whisperx[66].start |
1485.454 |
| transcript.whisperx[66].end |
1507.469 |
| transcript.whisperx[66].text |
執行醫師新取得認證資格後一年內如果沒有單獨主刀執行機械手臂相關輔助的手術則暫停其資格需要再接受再培訓課程使得恢復資格那如果要擔任指導醫師當然更嚴謹那我的意思是說我看這個啦我覺得婦科 |
| transcript.whisperx[67].start |
1509.551 |
| transcript.whisperx[67].end |
1536.15 |
| transcript.whisperx[67].text |
這個是什麼醫學會叫做婦產科內試競技微創醫學會的規範其實是蠻完整的那從上述的規範可以證明專科醫學會在這個制度當中可以扮演更積極的角色新進的醫療技術和設備的合格操作標準最低的訓練門檻指定醫師的資格這個專業的自律範疇真的不要交給醫院更不能交給廠商 |
| transcript.whisperx[68].start |
1538.271 |
| transcript.whisperx[68].end |
1563.511 |
| transcript.whisperx[68].text |
應該要交給醫學會那你們不可以憑以形式說從中榮事件你訂一個限縮在開刀房秩序業務人員不得帶刀這麼簡單粗糙的指引而是你必須從制度層次全心去檢視新技術導入後的訓練認證和責任架構是否健全 |
| transcript.whisperx[69].start |
1564.452 |
| transcript.whisperx[69].end |
1578.963 |
| transcript.whisperx[69].text |
所以你要去統籌結合各專科醫學會針對不同類型的新進醫療技術建立分級分專科的操作案訓練指引而不是一個概括性的手術開刀房的指引 |
| transcript.whisperx[70].start |
1580.305 |
| transcript.whisperx[70].end |
1593.68 |
| transcript.whisperx[70].text |
所以在這種狀況對病患而言我覺得站在病患的角度立委最重要我們要緊的不是你多快用上最新的設備而已而是能不能再確信執行手術的醫療團隊已經具備充分的專業訓練和經驗 |
| transcript.whisperx[71].start |
1599.566 |
| transcript.whisperx[71].end |
1614.255 |
| transcript.whisperx[71].text |
而不是在默許現在的醫療技術資本競逐的過程當中任由科技和新興的醫材的風險轉嫁給病人自己去承擔不能這樣子啊 |
| transcript.whisperx[72].start |
1615.886 |
| transcript.whisperx[72].end |
1634.802 |
| transcript.whisperx[72].text |
這樣 我跟你說 你給我最後我就只想講你們跟各個醫學會開會 每開完一次會給我們一次報告 給我們委員會報告那你們三個月內 你們到底開了幾次會 達成什麼共識 討論出什麼可以都送我們未還委員會給大家報告一下嗎 |
| transcript.whisperx[73].start |
1635.322 |
| transcript.whisperx[73].end |
1649.395 |
| transcript.whisperx[73].text |
可以 可以 我們把這整個這個制度把它規劃好不要變成開刀房 開刀房的指引而已不會 不會 不會 從源頭啦對 對 對 好 謝謝好 謝謝委員好 謝謝林淑芬委員發言接下來請盧憲義委員發言 |