國家菁英 No.42 第 11 卷第 2 期 % 關鍵字 : 法醫解剖法醫病理專科醫師病理專科法醫師法醫師法 26

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1 從世界各國法醫制度趨勢看我國法醫教考訓用制度專題從世界各國法醫制度趨勢看我國法醫教考訓用制度潘至信 * 曾柏元 ** 蕭開平 *** 摘要 Medical doctor, M.D. Anatomic pathologist, A.P. Forensic pathologist, F.P. Forensic autopsycause of death, COD Manner of death, MOD International Statistical Classification of Diseases and Related Health Problems, ICD Gross pathology Micropathology % * 法務部法醫研究所法醫病理組研究員 (Researcher, Institute of Forensic Medicine, Ministry of Justice, Department of Forensic Pathology) ** 法務部法醫研究所法醫病理組副研究員 (Associate Researcher, Institute of Forensic Medicine, Ministry of Justice, Department of Forensic Pathology) *** 法務部法醫研究所法醫病理組組長 (Director, Institute of Forensic Medicine, Ministry of Justice, Department of Forensic Pathology) 25

2 國家菁英 No.42 第 11 卷第 2 期 % 關鍵字 : 法醫解剖法醫病理專科醫師病理專科法醫師法醫師法 26

3 從世界各國法醫制度趨勢看我國法醫教考訓用制度專題 From the tendency of the modern forensic pathology to evaluate the education, examination, training and appointment of forensic pathology in Taiwan Chih Hsin Pan, Bo Yuan Tseng, Kai Ping Shaw Abstract In modern forensic system, the person who qualifiedly performing forensic autopsy needs the certificates of medical doctor (M.D.), anatomic pathologist (A.P.) and forensic pathologist (F.P.). Overall, the modern forensic system of the United State is most complete. The core task of the forensic autopsy is to identify or make a diagnosis of cause of death (COD) and determine manner of death (MOD). Cause of death needs conform to the disease diagnosis of International Statistical Classification of Diseases and Related Health Problems (ICD). Therefore, the identifier must be a medical doctor. The forensic external and internal examination of the bodies and microscope observation of tissue in forensic autopsy need the skills and methods of anatomic pathology that needs 4-full-year training of pathology to be a qualified anatomic pathologist. Besides the anatomic pathology training, to make a diagnosis of cause of death, a qualified forensic pathologist needs at least another one-full-year professional forensic pathology training. In Taiwan, since the performance of Forensic Medical Examiner Law on December 28th, 1996, there are many medico-legal officers who performed forensic inspection or external examination of the bodies, and issued the certificate of death without any certificate of medical doctor, anatomic pathologist or forensic pathologist. From April 2014 till now, Taiwan Society of Pathology has issued 29 forensic pathologist certificates. These qualified forensic pathologists have no right to perform forensic autopsy due to lack of the certificated of medico-legal officer. We suggest revising Forensic Medical Examiner Law as soon as possible. First, define the Chinese and English name and responsibilities in forensic pathologist, medical examiner, medicolegal officer and forensic technician. Second, forensic autopsy must be performed by a boarded and qualified forensic pathologist, that means who must owns all the certificates of medical doctor, anatomic pathologist and forensic pathologist. Therefore, it needs to establish the system of education, examination, training and appointment for forensic pathologist in Taiwan. Keywords: Forensic autopsy, Forensic pathologist, Medical examiner, Forensic Medical Examiner Law 27

4 國家菁英 No.42 第 11 卷第 2 期壹前言 (Histopathology) Biosafety Level 2+, BSL % % 4 28

5 從世界各國法醫制度趨勢看我國法醫教考訓用制度專題 9 13 貳世界各國法醫制度一美國 1959 American Board of Pathology 2005 National Association of Medical Examiners, N.A.M.E. Forensic Autopsy Performance Standards 2009 National Academy of Sciences Strengthening Forensic Science in the United Accreditation Council for Graduate Medical Education, ACGME 29

6 國家菁英 No.42 第 11 卷第 2 期 Medical Examiner, M.E. 20 Coroner/Medical Examiner Laws, by State. Centers for Disease Control and Prevention 二荷蘭 Dutch Society of Pathology 3. 2 Autopsy report

7 從世界各國法醫制度趨勢看我國法醫教考訓用制度專題三英格蘭及威爾斯 The Royal College of Pathologists, A 1 B C D C D A B C D Certificate of Completion of Training Confirming Eligibility for Specialist Registration 四香港五新加坡 Royal College Of Pathologists Of United Kingdom Royal College Of Pathologists Of Australia 30-40% Fellow 2 Joint Committee On Specialist Training, JCST) (Specialist Traing Committee, STC) % Certificate Of Specialist Accreditation, Pathology Singapore Medical Council 31

8 國家菁英 No.42 第 11 卷第 2 期 Certificate Of Specialist Registration, Pathology, Forensic Pathologist 六德國 2012 Bockholdt, 七法國 Mavroforou, 八日本補充說明解剖資格 : 一. 具備醫師或牙醫師資格者之解剖資格 : (1) 醫師國考資格取得後, 在 2 年內從事解剖病理或法醫學教室內從事法醫解剖有關的教育或研究, 或 5 年內在被適當的指導下解剖 5 例或獨立解剖 15 例者 (2)1 年之內在醫院或研究室獨立解剖 10 例以上, 並具有第一項資格者 (3) 大學教授或副教授離職後, 繼續任職於解剖相關單位者 (4) 不具以上資格但具有同等知識和技能者二. 不具醫師或牙醫師資格之解剖資格 : (1) 醫學或牙醫學相關的解剖學病理學法醫學的專任講師 5 年以上, 並從事解剖相關教育, 或在 5 年適當的指導下進行每年 10 例以上的解剖 ( 共 50 例以上 ), 含 25 例必須自己獨立解剖 (2) 大學的教授或副教授離職後, 繼續任職於解剖相關單位者 32

9 從世界各國法醫制度趨勢看我國法醫教考訓用制度專題九小結 ACGME MD AP FP ( AP+CP 5 ) * 1 MD, AP, FP MD, AP FP MD, FP AP AP MD, FP AP AP MD, FP AP AP MD AP FP AP MD AP FP AP MD AP FP AP 4 7 ( AP+CP 5 ) * 1 MD, AP, FP MD: Medical doctor AP: Anatomic pathologist( 解剖病理專科醫師 ) CP: Clinical pathologist( 臨床病理專科醫師 ) FP: Forensic pathologist( 法醫病理專科醫師 ) * 只有 AP 資格需訓練 4 年 ; 若訓練 AP+CP 資格需 5 年 33

10 國家菁英 No.42 第 11 卷第 2 期 (Medical Doctor,MD) 4-5 (ABP) (Anatomic Pathologist,AP) 1 ACGME (ABP) (Forensic Pathologist,FP) (Medical Examiner,ME) 34

11 從世界各國法醫制度趨勢看我國法醫教考訓用制度專題參臺灣的法醫師教考訓用制度現況與困境一法醫業務發展沿革二法醫師法施行後之法醫師教育 ( ) /

12 國家菁英 No.42 第 11 卷第 2 期 ( ) ( ) 三法醫師法施行後之法醫師考試 3 6 ( ) ( 200 ) 法醫師法於 94 年底制定公布, 95 年底正式施行, 其中第 4 條得應法醫師考試資格者有二, 一是經法醫學研究所畢業, 並經實習期滿成績及格, 領有畢業證書, 應法醫師考試及格 ; 另一是醫學牙醫學中醫學系畢業, 領有醫師牙醫師中醫師證書, 且修習法醫學程, 並經法醫實習期滿成績及格, 或經國內外法醫部門一年以上之法醫專業訓練, 領有證明文件者然考選部自 96 年起辦理法醫師高考, 從報考人背景觀察, 以法醫學研究所畢業者為主, 幾無第二種管道人員, 究其原因為法醫師法針對第一款法醫學研究所應修課程有訂定細則, 而第二款修習法醫學程, 並無訂定施行細則, 以致醫師無明確法條或辦法可應法醫師考試四法醫師法施行後之法醫師訓練

13 從世界各國法醫制度趨勢看我國法醫教考訓用制度專題 ( ) 五法醫師法施行後之法醫師任用 1.() Forensic Physician Forensic Physician 37

14 國家菁英 No.42 第 11 卷第 2 期 Certificate Of Death Anatomic Pathology Forensic Pathology ( ) 5 38

15 從世界各國法醫制度趨勢看我國法醫教考訓用制度專題肆臺灣的法醫病理專科醫師訓練及甄審制度 % % Forensic Pathologist 29 9 伍法醫師法所面臨之問題與建議一定義不清 ( 一 ) 法醫病理專科醫師 (Forensic Pathologist, F.P.) Forensic Pathologist F.P. 39

16 國家菁英 No.42 第 11 卷第 2 期 ( 二 ) 病理專科法醫師 (Medical Examiner, M.E.) Medical Examiner M.E. ( 三 ) 法醫師 (Medico-legal Officer) Forensic physician physician Medico-legal Officer ( 四 ) 檢驗員 (Forensic Technician) Forensic Technician ( 五 ) 顧問病理專科法醫師 (Consultant Medical Examiner, Consultant M.E.) Consultant Medical Examiner Consultant M.E. 現行中文職稱英文職稱職掌 Forensic Pathologist, F.P. Medical Examiner, M.E. Medico-legal Officer Forensic Technician Consultant Medical Examiner, Consultant M.E. 40

17 從世界各國法醫制度趨勢看我國法醫教考訓用制度專題二資格不符陸結論參考資料 2011 NFI HSA (15) National Association of Medical Examiners (2005). Forensic Autopsy Performance Standards. National Academy of Sciences (2009). Strengthening Forensic Science in the United: A Path Forward. Accreditation Council for Graduate Medical Education (2013). ACGME Program Requirements for Graduate Medical Education in Forensic Pathology. Bockholdt, B., Rothschild, M. A., Ehrlich, E., Maxeiner, H., & Schneider, V. (2001) "Medical studies and training duration for forensic pathologists in Germany," Leg Med (Tokyo), 3:

18 國家菁英 No.42 第 11 卷第 2 期 The Royal College of Pathologists (2012). Curriculum for specialty training in Forensic Histopathology. Mavroforou, A., & Michalodimitrakis, E. (2002) "Forensic pathology on the threshold of the 21st century and the need for harmonization of current practice and training: the Greek concept," Am J Forensic Med Pathol, 23: Coroner/Medical Examiner Laws, by State. Centers for Disease Control and Prevention. 42

A Study of the Japanese Teacher Education Reform Szu-Wei Yang President of national Taichung University Sheng-Hsien Chen Doctor Candidate, Department

A Study of the Japanese Teacher Education Reform Szu-Wei Yang President of national Taichung University Sheng-Hsien Chen Doctor Candidate, Department 日本教師教育改革之研究楊思偉臺教育大校長陳盛賢臺灣師範大教育系博士候選江志正臺教育大教育系副教授摘要進入 21 世紀的今日, 日本教師教育政策面臨最重大的挑戰而其主要理由不僅是因為教育荒廢而已, 更因為在高度經濟

國家菁英 No.42 第 11 卷第 2 期 % 關鍵字 : 法醫解剖 法醫病理專科醫師 病理專科法醫師 法醫師法 26

國家菁英 No.42 第 11 卷第 2 期 % 關鍵字 : 法醫解剖法醫病理專科醫師病理專科法醫師法醫師法 26