美容醫學應否適用消費者保護法之研究－從美容醫學與一般必要性醫療之異同談起

民國93年4月醫療法修正通過，第82條第2項明文規定：「醫療機構及其醫事人員因執行業務致生損害於病人，以故意或過失為限，負損害賠償責任。」本條之立法意旨係為避免一般必要性醫療若採無過失責任，則會造成防禦性醫療之產生，誠非病患與社會之益。雖修法後認定醫療行為不適用無過失責任規定，但醫療行為是否適用消保法其他規定，則未明文。然，新興醫療型態之美容醫學出現，人們不再單純為了治癒疾病進而追求外觀美貌，破除了一般必要性醫療之特性，此種「非治療性」且「非必要性」醫療的美容醫學服務，缺乏公益性且具消費營利特性，本文認為法律適用應與一般必要性醫療區別。又，我國消費者保護法未對服務設有定義性之文字，故本文加以分析美容醫學適用消費者保護法之理由。 研究方法上係以文獻分析法、美容醫學相關判決書內容分析法、美容醫學使用者之深度訪談法、筆者實際訪查美容醫學診所之參與觀察法，藉此推論出美容醫學之特性加以定性，亦從中了解美容醫學產業真實狀況以提出法律適用上之疑義。 管見認為我國應加強於美容醫學處置分類及美容醫學作業方面的能力要求、針對美容醫學廣告管制、美容醫學手術作業標準與美容醫學道德規範之建立。另，本文建議醫療法第82條第2項修法增訂但書：「但非以治療疾病目的之醫療行為，不在此限。」此種修法方式，則區分一般必要性醫療行為與非必要醫療行為，一則保護美容醫學消費者的權益，二則可據其反面解釋，更進一步確認「一般必要性醫療行為」適用過失責任之立法意旨。

In 2014 April, Medical Care Act amend Article 82 section 2 “Medical care institutions and their medical personnel who harm patients in the execution of practice, whether deliberate or by accident, shall be responsible for compensation.” The purpose of this article is to avoid “Defensive Medicine” happen when the essential medical procedures apply to the no-fault liability, because Defensive Medicine won’t benefit the patients and the whole society. As a result, medical practice does not apply to strict liability after amending Medical Care Act. However, it doesn’t show medical practice is applicable Consumer Protection Law or not. Nowadays, people are no longer only to cure disease but to pursue the appearance of beauty. Therefore, new type of medical treatments appears - Aesthetic Medicine. This kind of medical treatment breaks down the traits of the essential medical procedures, such as "non-therapeutic" and "non-essential". Aesthetic Medicine which is losing sight of public welfare is actually a business guided by market structures aimed primarily at material gain and profit. Therefore, this study discusses the difference between Aesthetic Medicine and Medical Necessity, and why they should have the different applications of law. In Taiwan, Consumer Protection Law doesn’t define “the service”, so this study analyzed the reasons why Aesthetic Medicine should include in “the service” that should apply to Consumer Protection Law. The method of this study were Documentary Analysis, Content Analysis of the judgments relate to the Aesthetic Medicine, in-depth interview of the Aesthetic Medicine users, Participant Observation of the Aesthetic Medicine clinics, infer a conclusion from the fact that can realize the traits of the Aesthetic Medicine and question the way Aesthetic Medicine apply to the law. The results of this study would provide useful information in drawing related regulations, policies and management strategies. Key words: Cosmetic medicine, consumer protection laws, the non-necessity of medical care, medical cosmetic, medical disputes.