Taiwan’s medical dispute mediation mechanism appears to provide patients with a pathway for compensation. In reality, it is an institutional charade that places patients at a disadvantage.
Taipei, despite having the highest concentration of medical resources nationwide, does not even have a basic professional support team for mediation. Instead, just two mediators — one with a legal background and one with a medical background — conduct the process in a setting of severe informational imbalance.
By contrast, cities like New Taipei City and Hsinchu at least offer preliminary professional reviews before the actual mediation. That Taipei, a metropolis with vast resources, cannot even match these basic provisions is absurdly unbalanced — so obvious that even a blind person could see it. If this is not a blatant example of the medical community shielding itself, who would believe otherwise?
Even more absurd is that the mediation process begins with “the patient proposing a compensation amount.” How much is a life lost to medical negligence worth? If the patient’s family demands too much, the mediation panel dismisses the case with a perfunctory process, exhausting the patient’s family in a lengthy and futile battle, ultimately forcing them into silent resignation.
Is this a reasonable mediation system, or is it simply a delay tactic to wear down the victims?
As for the argument of “using criminal charges to pressure civil settlements,” the medical community repeatedly employs it as a shield. Criminal liability can range from minor to severe, yet it is used as a bargaining chip, coercing patients’ families into accepting unfair civil settlements under the weight of “minor criminal charges.”
Is medical negligence resulting in death merely a “minor criminal offense”? If this logic holds, then should last year’s case of an elderly man in Changhua who died from a perforated intestine also be treated lightly? Just because the medical community controls the narrative, can they downplay the severity of wrongful deaths, shifting responsibility while leaving grieving families with no recourse?
That said, the Medical Accident Prevention and Dispute Resolution Act (醫療事故預防及爭議處理法) is not entirely without merit. One of its few redeeming features is the medical review system, which allows the mediation committee to refer cases to professional medical institutions for review and issue written reports. This enables patients’ family to gain a clearer understanding of the extent of medical negligence and even question or challenge the findings.
By providing a more balanced information flow, this mechanism prevents hospitals from monopolizing case narratives and offers families a stronger foundation for further legal action or negotiations.
Medical dispute mediation should serve as a patient protection mechanism, but it has become a game of shielding the medical industry. Mediation without professional support teams is mere negligence, forcing patients’ families to propose settlement figures is a distortion, and using minor criminal charges to suppress major civil claims is outright judicial coercion.
If the legal and medical communities genuinely wish to resolve medical disputes, they should focus on improving healthcare quality and reducing professional negligence, rather than using “criminal threats” as a shield that further deteriorates the doctor-patient relationship. Can a mediation system like this still be called just?
The legal, medical and judicial systems should serve as the last line of defense for social justice. Judges, lawyers and doctors, as “agents of goodwill,” are entrusted with professional authority, and bear the responsibility of upholding justice and protecting lives.
However, when these agents betray that trust, they are no longer merely negligent, but become perpetrators in the eyes of victims’ families. How should we face the betrayal of these “agents of goodwill”?
For many families involved in medical disputes, the first obstacle they encounter is the hospital’s silence and dismissiveness. Medical negligence is often disguised as “unexpected disease progression” or “unpredictable complications,” with technical jargon used to obscure accountability.
The most fundamental countermeasure is to obtain comprehensive medical records, review reports and seek analyses from independent medical experts to uncover the truth — what actually happened and what the hospital is trying to hide.
Moreover, the law is a tool, not the only solution. When criminal responsibility is downplayed and civil compensation minimized, families do not face justice, but rather a cold and impersonal judicial system.
Therefore, beyond legal battles, it is crucial to leverage public opinion, social pressure and even political reform to hold the medical community accountable. Ultimately, systemic reform is necessary to prevent future victims. True justice is not about punishing one doctor; it is about ensuring that no one else suffers the same fate.
When agents of goodwill become adversaries who take away our loved ones, some choose legal action, some expose the truth and others push for reform. Every path is difficult, but the most important thing is to prevent these “agents” from continuing to hide behind institutional shadows, using their professional status to evade responsibility.
Fighting an unjust system is never a battle fought alone — it is the collective outcry of countless bereaved families. Perhaps, one day, this shared pain would lead to a better future.
Chu Jou-juo is a professor in the Department of Labor Relations at National Chung Cheng
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