{"error":false,"id":["168983"],"data":{"IVOD_ID":168983,"IVOD_URL":"https://ivod.ly.gov.tw/Play/Clip/1M/168983","日期":"2026-04-29","會議資料":{"會議代碼":"委員會-11-5-26-8","會議代碼:str":"第11屆第5會期社會福利及衛生環境委員會第8次全體委員會議","屆":11,"會期":5,"會次":8,"臨時會會次":null,"種類":"委員會","委員會代碼":[26],"委員會代碼:str":["社會福利及衛生環境委員會"],"標題":"第11屆第5會期社會福利及衛生環境委員會第8次全體委員會議"},"影片種類":"Clip","開始時間":"2026-04-29T16:14:42+08:00","結束時間":"2026-04-29T16:28:01+08:00","影片長度":"00:13:19","支援功能":["ai-transcript","gazette"],"video_url":"https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/6301273cb2dfee84ee6f852fbc51105084e55221ec8869c0f4adde2d2cfc6c0fc85f38e9dc6d1ac45ea18f28b6918d91.mp4/playlist.m3u8","委員名稱":"林月琴","委員發言時間":"16:14:42 - 16:28:01","會議時間":"2026-04-29T14:30:00+08:00","會議名稱":"立法院第11屆第5會期社會福利及衛生環境委員會第8次全體委員會議（事由：（下午2時30分起。若上午議程尚未結束，待結束後接續召開）\n一、繼續審查\n(一)委員柯志恩等17人擬具「醫療法第二十四條及第一百零六條條文修正草案」案。\n(二)委員林月琴等17人擬具「醫療法第二十四條及第一百零六條條文修正草案」案。\n(三)委員王育敏等16人擬具「醫療法第二十四條及第一百零六條條文修正草案」案。\n......(因系統字數上限，詳見議事日程)\n二、審查\n(一)委員徐欣瑩等18人擬具「醫療法第二十一條條文修正草案」案。\n(二)委員洪申翰、賴惠員等17人擬具「醫療法部分條文修正草案」案。\n(三)委員盧縣一等16人擬具「醫療法第七十一條條文修正草案」案。\n(四)委員鍾佳濱等19人擬具「醫療法第八十四條條文修正草案」案。\n(五)委員王正旭等24人擬具「醫療法增訂第七十一條之一條文草案」案。\n(六)台灣民眾黨黨團擬具「醫療法第一百零三條條文修正草案」案。\n(七)委員郭昱晴等16人擬具「醫療法第一百零三條條文修正草案」案。\n(八)委員盧縣一等17人擬具「醫療法第四十九條及第五十條條文修正草案」案。\n(九)委員蘇巧慧等19人擬具「醫療法增訂第二十二條之一條文草案」案。\n(十)委員賴惠員等20人擬具「醫療法第八十四條及第一百零四條條文修正草案」案。\n(十一)委員李彥秀等16人擬具「醫療法部分條文修正草案」案。\n(十二)委員陳瑩等16人擬具「醫療法第八十八條條文修正草案」案。\n(十三)委員劉建國等18人擬具「醫療法第二十四條及第一百零六條條文修正草案」案。\n(十四)委員劉建國等16人擬具「醫療法第四十九條及第五十條條文修正草案」案。\n(十五)委員邱鎮軍等21人擬具「醫療法第二十四條及第一百零六條條文修正草案」案。\n(十六)委員劉建國等16人擬具「醫療法增訂第九十八條之一條文草案」案。\n(十七)委員林思銘等23人擬具「醫療法第二十四條及第一百零六條條文修正草案」案。\n(十八)委員羅智強等16人擬具「醫療法第二十四條及第一百零六條條文修正草案」案。\n(十九)委員張嘉郡等17人擬具「醫療法第二十四條及第一百零六條條文修正草案」案。\n(二十)委員蘇清泉等22人擬具「醫療法部分條文修正草案」案。\n(二十一)委員羅明才等16人擬具「醫療法第十條、第二十四條及第一百零六條條文修正草案」案。\n(二十二)台灣民眾黨黨團擬具「醫療法第二十四條及第一百零六條條文修正草案」案。\n(二十三)委員許宇甄等21人擬具「醫療法第二十四條及第一百零六條條文修正草案」案。\n(二十四)委員廖偉翔等19人擬具「醫療法第一百零二條條文修正草案」案。\n【第二(二十四)案，如未經各黨團簽署不復議同意書，則不予審查】\n【僅詢答，下午1時30分起辦理發言】\n【4月29日上午9時起及下午2時30分起為一次會】）","transcript":{"pyannote":[{"speaker":"SPEAKER_01","speaker_name":"林委員月琴","start":4.232843750000001,"end":6.03846875,"speaker_score":0.98},{"speaker":"SPEAKER_00","speaker_name":"石部長崇良","start":6.072218750000001,"end":7.16909375,"speaker_score":0.829},{"speaker":"SPEAKER_01","speaker_name":"林委員月琴","start":8.215343750000002,"end":9.480968750000002,"speaker_score":0.98},{"speaker":"SPEAKER_00","speaker_name":"石部長崇良","start":10.662218750000001,"end":10.797218750000003,"speaker_score":0.829},{"speaker":"SPEAKER_01","speaker_name":"林委員月琴","start":10.797218750000003,"end":11.57346875,"speaker_score":0.98},{"speaker":"SPEAKER_01","speaker_name":"林委員月琴","start":14.290343750000002,"end":15.387218750000002,"speaker_score":0.98},{"speaker":"SPEAKER_01","speaker_name":"林委員月琴","start":16.51784375,"end":17.17596875,"speaker_score":0.98},{"speaker":"SPEAKER_01","speaker_name":"林委員月琴","start":18.289718750000002,"end":19.01534375,"speaker_score":0.98},{"speaker":"SPEAKER_01","speaker_name":"林委員月琴","start":19.38659375,"end":67.83471875000001,"speaker_score":0.98},{"speaker":"SPEAKER_00","speaker_name":"石部長崇良","start":69.67409375,"end":167.49846875,"speaker_score":0.829},{"speaker":"SPEAKER_01","speaker_name":"林委員月琴","start":80.03534375000001,"end":80.62596875,"speaker_score":0.98},{"speaker":"SPEAKER_01","speaker_name":"林委員月琴","start":88.52346875,"end":88.92846875000001,"speaker_score":0.98},{"speaker":"SPEAKER_01","speaker_name":"林委員月琴","start":108.13221875,"end":108.52034375000001,"speaker_score":0.98},{"speaker":"SPEAKER_01","speaker_name":"林委員月琴","start":108.53721875000001,"end":108.62159375,"speaker_score":0.98},{"speaker":"SPEAKER_01","speaker_name":"林委員月琴","start":133.96784375000001,"end":134.40659375,"speaker_score":0.98},{"speaker":"SPEAKER_01","speaker_name":"林委員月琴","start":144.80159375,"end":145.83096875,"speaker_score":0.98},{"speaker":"SPEAKER_01","speaker_name":"林委員月琴","start":155.66909375,"end":156.66471875000002,"speaker_score":0.98},{"speaker":"SPEAKER_01","speaker_name":"林委員月琴","start":167.17784375000002,"end":171.02534375000002,"speaker_score":0.98},{"speaker":"SPEAKER_01","speaker_name":"林委員月琴","start":171.12659375,"end":198.98721875,"speaker_score":0.98},{"speaker":"SPEAKER_00","speaker_name":"石部長崇良","start":177.45471875,"end":177.55596875,"speaker_score":0.829},{"speaker":"SPEAKER_00","speaker_name":"石部長崇良","start":177.58971875,"end":177.75846875000002,"speaker_score":0.829},{"speaker":"SPEAKER_00","speaker_name":"石部長崇良","start":188.60909375,"end":189.09846875000002,"speaker_score":0.829},{"speaker":"SPEAKER_01","speaker_name":"林委員月琴","start":199.25721875000002,"end":204.11721875,"speaker_score":0.98},{"speaker":"SPEAKER_01","speaker_name":"林委員月琴","start":204.52221875,"end":227.16846875000002,"speaker_score":0.98},{"speaker":"SPEAKER_01","speaker_name":"林委員月琴","start":227.64096875,"end":231.31971875000002,"speaker_score":0.98},{"speaker":"SPEAKER_01","speaker_name":"林委員月琴","start":231.67409375000003,"end":235.72409375,"speaker_score":0.98},{"speaker":"SPEAKER_01","speaker_name":"林委員月琴","start":236.09534375,"end":257.72909375,"speaker_score":0.98},{"speaker":"SPEAKER_01","speaker_name":"林委員月琴","start":257.91471875,"end":280.00409375000004,"speaker_score":0.98},{"speaker":"SPEAKER_00","speaker_name":"石部長崇良","start":280.86471875,"end":288.96471875000003,"speaker_score":0.829},{"speaker":"SPEAKER_01","speaker_name":"林委員月琴","start":284.79659375,"end":285.13409375000003,"speaker_score":0.98},{"speaker":"SPEAKER_01","speaker_name":"林委員月琴","start":286.41659375,"end":286.66971875,"speaker_score":0.98},{"speaker":"SPEAKER_01","speaker_name":"林委員月琴","start":287.14221875000004,"end":287.46284375,"speaker_score":0.98},{"speaker":"SPEAKER_00","speaker_name":"石部長崇良","star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我們的人力就是比較低的時候病人也要休息 護理的人力也是比較少"},{"start":304.435,"end":327.922,"text":"所以盡可能的很多的病情解釋或者是探視盡量在白天不要去干擾到醫療業務的進行這個其實相對的也是可以讓護理人員或者我們的醫護人員多一些時間來照顧病人所以我想這幾年我們一直在希望"},{"start":330.823,"end":347.048,"text":"為第一線的人員減壓但是也希望民眾能夠配合所以這個行為我認為是一個不好的示範所以我說我們當然就不允許有醫療壓力更何況我們更不能允許醫療暴力常態化可是根據統計醫療暴力案件數從110"},{"start":350.109,"end":352.23,"text":"面對醫療暴力持續攀升衛福部目前的整體對策是什麼"},{"start":371.67,"end":389.401,"text":"我想這個我們當然幾個部分透過這個修法師意圖那麼過去因為沒有這個最低的這個刑事責任的限制所以呢造成很多最後都用一顆罰金達不到那個渴止的效果"},{"start":389.701,"end":412.89,"text":"所以這一次幾位委員提出的版本去訂定這個刑事責任的這個下限就是最低門檻那麼這個有助於產生這個賀旨的作用當然第二個我們也會去強化這個警民之間的合作如何的及時通報尋求這個警方的協助當然也要強化這個醫院內部"},{"start":415.111,"end":443.547,"text":"自行的應變能力當然這個包含如何處理這個比較會有產生這個暴力行為的像這個酗酒 藥酒飲的患者那麼這一些呢是比較會有暴力行為如何防範這些應該要融入在我們的教育訓練裡頭醫院內部的因應的機制這些都應該要要同步的進行我要提醒的是因為如果市長立法院不斷拉高我們的刑責的一個天花板"},{"start":444.367,"end":461.832,"text":"可法院卻停留在地板的一個落差因為單純的加重醫療暴力刑責招就已經沒有嚇阻的效果在避免衝突發生還是要前端預防我相信你應該非常了解像就舉例台大醫院的雲林分院的白色小組的機制為例這個小組從行政總值"},{"start":465.613,"end":490.811,"text":"值班阿長跟保全來做組成只要醫事人員發現到有狀況的時候馬上透過電腦系統或撥打專線那同時就用一個術語叫白色一號那三分鐘內白色小組就會到場來進入協調那相對醫事人員也會感受到是有人來協助他們的話那這個機制運作效果良好可是白色小組實施後呢隔年那個"},{"start":491.631,"end":515.25,"text":"醫療暴力呢降為零件我認為這事實上是值得借鏡的模式可是我要問那目前有沒有想要去參考這樣的模式來做推行我想這個醫院內部一定要建立這樣的應變流程這個是應該要有所以我們會來研議把它放到評鑑裡頭這個也是對病人還有對所有的從業人員的一個安全維護這個是醫院應該要有的這個做法"},{"start":519.273,"end":545.865,"text":"至於怎麼樣做得更好可以透過一些互相的標竿學習來去落實我想這個我們可以來推動接著我要問的是近這幾年衛福部一直努力的育立醫療那它不只事實上是一個醫療上的選擇更是尊重個人的自主權跟尊嚴同時也緊急家長在臨床的時候要去做決策的壓力跟衝突目前的整個的成效 政策成效是什麼"},{"start":546.745,"end":561.454,"text":"跟委員說我們分兩階段第一階段是從113年7月我們先開放了部分條件住院的時候健保去給ACP簽這個預定醫療決定這個實施了一段時間到113年7月到114年4月這當中真正申報的才190個所以量非常的少"},{"start":572.481,"end":596.416,"text":"所以我們就在檢討之後從114年5月開始我們就擴大適用健保可以給付的ACP的條件65歲以上只要有重大傷病的我們就可以給付在門診就可以做那另外如果有加一計畫或者是多重慢性病65歲以上的也可以做"},{"start":597.256,"end":621.378,"text":"那到目前為止大概差不多近兩千個啦所以叫前一波的那個政策當然已經大幅提升了不過呢還是有很大的努力空間因為我們預估這樣的這個族群大概是超過一百萬人才對所以我們會在幾個方向來努力第一個就是這個之前也有委員提案要修這個病毒法"},{"start":622.259,"end":637.604,"text":"去擴大這個放這個擴大這個可以做ACP的一些機構可以讓更多的因為我們現在都一定要醫療機構才能做嘛所以這個醫療機構能做大概400多家這個這個可進性比較低啦"},{"start":638.344,"end":656.486,"text":"而且醫護人員其實也很忙了所以如何去擴大讓大家更多的參與進來包含診所 包含其他的醫師機構或者是專業的團體來推動那也許可以讓這個更普及一點這個我們可以來檢討努力"},{"start":657.487,"end":671.176,"text":"對 我覺得是不是根本問題就是民眾不太理解也不願意談死亡所以我覺得可不可以比照像英國的方式就是說我們在推動預例醫療的時候並不是把重點放在宣傳而是直接放進到醫療體系裡面去運作"},{"start":673.718,"end":698.611,"text":"在國民健康服務的體系當中育育醫療是由醫療人員主動在適當時機去啟動例如在慢性疾病追蹤啊高齡照護啊或健康狀況惡化的過程當中因為家醫事實上是他比較常互動他也是比較信任的人有我們的這樣的照護團隊直接去跟家人跟病人開啟對話的討論而不是又要拉出來去宣傳我覺得這樣的效果所以部長可不可以朝這個方向來"},{"start":699.411,"end":718.479,"text":"其實跟委員說明這個目前大家一計畫啦居整計畫啦長照啦跟住院整個都已經可以用ACP這個已經納入了只是說可能在落實度或者是推動上還要一點時間因為要準備好嘛所以這個其實我們已經納入這四個計畫都已經納入可以執行ACP"},{"start":722.681,"end":739.571,"text":"最後一個就是今年我在質詢醫院質詢的時候就希望每一個身上朋友能爭取到醫院設置身上婦產科特別門診讓他們就醫的時候就能夠真正實現平權後來你們回文也是說這個月底公告辦法的修訂"},{"start":740.391,"end":754.404,"text":"部長今天29號可是遲到現在我們都還沒有看到任何我覺得部長辦法定好了嗎什麼時候公告如果還沒有辦法公告明天你可以公告嗎你本來講4月底今天5月初一定會預告"},{"start":755.145,"end":777.916,"text":"你的五月初會出到什麼時候出我也不太確定我就不知道到底困難是什麼因為大家等著這個要使用這個資源可是都沒有辦法所以無論如何我覺得提供身障夥伴一個具有可靜性的醫療環境的話是我們必須努力的目標所以部長在這邊你剛剛承諾五月初兩個禮拜內我們預告"},{"start":780.377,"end":794.641,"text":"這個就不是五月初了就不是五月初兩個禮拜不是五月初那已經進入到五月中了所以下週是不是可以公開下個禮拜我們努力啦因為條文出來還要會這個法規單位啊等等這樣最晚兩週內兩週內好 謝謝謝謝 謝謝委員謝謝連夜前召會的質詢"}],"gazette":[{"speaker":"林委員月琴","start":"2026-04-29T16:14:42+08:00","guessed":true,"end":"2026-04-29T16:14:43+08:00","text":"謝謝主席。","quality":0},{"speaker":"林委員月琴","start":"2026-04-29T16:14:43+08:00","guessed":true,"end":"2026-04-29T16:14:44+08:00","text":"請石部長。","quality":0},{"speaker":"主席","start":"2026-04-29T16:14:44+08:00","guessed":true,"end":"2026-04-29T16:14:45+08:00","text":"請石崇良部長。","quality":0},{"speaker":"石部長崇良","start":"2026-04-29T16:14:44.597000+08:00","guessed":false,"end":"2026-04-29T16:14:44.817000+08:00","text":"林委員好。","quality":0.75},{"speaker":"林委員月琴","start":"2026-04-29T16:14:56.572000+08:00","guessed":false,"end":"2026-04-29T16:14:56.873000+08:00","text":"部長午安。","quality":1},{"speaker":"林委員月琴","start":"2026-04-29T16:15:00.316000+08:00","guessed":false,"end":"2026-04-29T16:15:22.836000+08:00","text":"部長好，剛剛有一則獨家新聞，說衛福部和醫界、護理界討論多時的三班護病比終於有了新的進展，衛福部將護病比納入醫療機構設置標準，且訂有兩年的緩衝時間，預計118年正式實施，我想要給部長一個肯定。","quality":0.976},{"speaker":"林委員月琴","start":"2026-04-29T16:15:23.537000+08:00","guessed":false,"end":"2026-04-29T16:15:29.098000+08:00","text":"其實不只是這樣，衛福部早就頒布了許多有關護理人員的獎勵方案。對。","quality":0.931},{"speaker":"林委員月琴","start":"2026-04-29T16:15:29.258000+08:00","guessed":false,"end":"2026-04-29T16:15:40.341000+08:00","text":"而護理師最近確實也有回流的趨勢，顯示政策方向可能是對的，但還是有定期檢視現況的必要性，讓護理師能夠得到真正的保障。","quality":0.943},{"speaker":"林委員月琴","start":"2026-04-29T16:15:40.962000+08:00","guessed":false,"end":"2026-04-29T16:15:45.643000+08:00","text":"另外我要問部長，剛剛有在野黨委員質詢的時候說，衛福部又突襲了，賴總統又突襲宣布要入法。","quality":0.949},{"speaker":"林委員月琴","start":"2026-04-29T16:15:45.703000+08:00","guessed":false,"end":"2026-04-29T16:15:45.723000+08:00","text":"請問是這樣嗎？","quality":1},{"speaker":"石部長崇良","start":"2026-04-29T16:15:52.027000+08:00","guessed":false,"end":"2026-04-29T16:16:09.897000+08:00","text":"這個其實是大家一向關切的議題，護理人員是醫療體系不可或缺的支柱，前幾年因為疫情的關係太勞累了，所以在疫情後端的時候就開始出現護理人力流失。","quality":0.923},{"speaker":"石部長崇良","start":"2026-04-29T16:16:11.678000+08:00","guessed":false,"end":"2026-04-29T16:16:25.545000+08:00","text":"有一年我還記得很清楚，那一年整個醫院新增的護理人力才300名，這個和關床、候床、急診壅塞等情形都有相關聯性。","quality":0.848},{"speaker":"石部長崇良","start":"2026-04-29T16:16:26.105000+08:00","guessed":false,"end":"2026-04-29T16:16:39.131000+08:00","text":"不過經過我們的努力，去年健保點值提升了，今年健保總額又超過1兆元，也特別調整護理費。","quality":0.973},{"speaker":"石部長崇良","start":"2026-04-29T16:16:39.291000+08:00","guessed":false,"end":"2026-04-29T16:17:02.003000+08:00","text":"另外，我們也有護理12項改革計畫，從去年開始推動，四年275億元，再加上零零總總的，還有住院的整合照護計畫也在分擔護理人員的照顧壓力等等，有很多措施在進行，我們的目的都是希望得到平衡。","quality":0.937},{"speaker":"石部長崇良","start":"2026-04-29T16:17:02.184000+08:00","guessed":false,"end":"2026-04-29T16:17:28.561000+08:00","text":"一方面能夠讓護理的工作職場更好，包含薪資的改善、條件的改善，但是也要兼顧到整個醫療體系的穩定運作，病人要住院也不會有困難，這些我們都有負責任的推動，不是說今天要入法就入法，所以我們才需要這樣一步、一步的進行。","quality":0.968},{"speaker":"林委員月琴","start":"2026-04-29T16:17:33.504000+08:00","guessed":false,"end":"2026-04-29T16:17:48.878000+08:00","text":"所以我要嚴正的幫部長澄清，三班護病比入法在衛福部討論非常久了，光是我自己和護理師、醫師等相關團體，就和衛福部討論非常多次，絕對不是在野黨委員講的又突襲處理，一句話就否定衛福部和其他委員的努力，我認為這樣子非常不妥。","quality":0.727},{"speaker":"石部長崇良","start":"2026-04-29T16:17:48.878000+08:00","guessed":true,"end":"2026-04-29T16:17:50.840000+08:00","text":"謝謝委員。","quality":0},{"speaker":"林委員月琴","start":"2026-04-29T16:17:50.840000+08:00","guessed":false,"end":"2026-04-29T16:17:56.483000+08:00","text":"努力的人都沒辦法為自己說說話，所以在這邊也要澄清。","quality":0.957},{"speaker":"林委員月琴","start":"2026-04-29T16:17:57.343000+08:00","guessed":false,"end":"2026-04-29T16:18:12.332000+08:00","text":"再來，關於醫療暴力，我認為給予所有在第一線奮鬥的醫事人員基本保障，事實上這是一定要做的事情，我也在上週新增提案，擴大對於醫療暴力人員保障的適用範圍，讓緊急醫療人員也可以被納入。","quality":0.988},{"speaker":"林委員月琴","start":"2026-04-29T16:18:15.274000+08:00","guessed":false,"end":"2026-04-29T16:18:18.456000+08:00","text":"可是除了醫療暴力之外，我更在乎的是醫療壓力。","quality":1},{"speaker":"林委員月琴","start":"2026-04-29T16:18:19.156000+08:00","guessed":false,"end":"2026-04-29T16:18:42.348000+08:00","text":"上週有前市長、前急診科醫師在非開放時間前往護理站詢問病情一事，我要先強調，並不是不能關心病情，但不管是誰都應該遵守相關規範，更何況這個人是醫生、是前市長，讓所有人都很有壓力要來配合，我認為這對醫事人員的負擔非常大。","quality":0.99},{"speaker":"林委員月琴","start":"2026-04-29T16:18:42.548000+08:00","guessed":false,"end":"2026-04-29T16:18:49.792000+08:00","text":"院方也坦白說，他說話的方式就是電視上常見的典型柯式語法，即使沒有什麼惡意，聽起來也很有壓力。","quality":0.929},{"speaker":"林委員月琴","start":"2026-04-29T16:18:50.313000+08:00","guessed":false,"end":"2026-04-29T16:18:56.996000+08:00","text":"類似這樣的感受，這就是赤裸裸的，第一線醫護人員感受到的壓力和緊繃。","quality":0.967},{"speaker":"林委員月琴","start":"2026-04-29T16:18:57.697000+08:00","guessed":false,"end":"2026-04-29T16:19:21.721000+08:00","text":"當有影響力或者具有社會知名度的人進入醫療的場域，即便是在關心病情的前提下，仍然可能讓現場的人產生不對等的溝通壓力，甚至影響到醫療場域當中應有的中立和常態運作，這是不是也應該納入醫療法討論，強化對醫事人員權益的保障？","quality":0.97},{"speaker":"石部長崇良","start":"2026-04-29T16:19:23.662000+08:00","guessed":false,"end":"2026-04-29T16:19:36.269000+08:00","text":"其實對這個事情評論，我也很有壓力，我也很怕他又要丟我病歷，但是我認為應該要講。","quality":1},{"speaker":"林委員月琴","start":"2026-04-29T16:19:36.269000+08:00","guessed":true,"end":"2026-04-29T16:19:37.269000+08:00","text":"是，一定要講啊！","quality":0},{"speaker":"石部長崇良","start":"2026-04-29T16:19:36.269000+08:00","guessed":false,"end":"2026-04-29T16:20:06.401000+08:00","text":"醫院裡面有一定的規範，特別是夜間人力就是比較低，病人要休息，護理人力也比較少，所以儘可能很多的病情解釋或者是探視，儘量在白天，不要干擾到醫療業務的進行；相對的，也可以讓護理人員或醫護人員有多一些間來照顧病人。","quality":0.968},{"speaker":"石部長崇良","start":"2026-04-29T16:20:08.422000+08:00","guessed":false,"end":"2026-04-29T16:20:22.706000+08:00","text":"這幾年我們一直希望能為第一線的人員減壓，但也希望民眾能夠配合，所以這個行為是個不好的示範。","quality":0.976},{"speaker":"林委員月琴","start":"2026-04-29T16:20:23.606000+08:00","guessed":false,"end":"2026-04-29T16:20:27.888000+08:00","text":"如果大家是在壓力之下離開，反而不是好事；我們當然不允許有醫療壓力，更不允許醫療暴力常態化。","quality":0.561},{"speaker":"林委員月琴","start":"2026-04-29T16:20:27.888000+08:00","guessed":true,"end":"2026-04-29T16:20:32.109000+08:00","text":"可是根據統計，醫療暴力案件數從110年的284件到114年的443件，短短四年當中成長了5成；常見的行為樣態有推擠、拉扯、辱罵，到持續性攻擊這種嚴重的暴力事件。","quality":0.233},{"speaker":"林委員月琴","start":"2026-04-29T16:20:32.109000+08:00","guessed":false,"end":"2026-04-29T16:20:34.230000+08:00","text":"請問部長，面對醫療暴力持續攀升，衛福部目前的整體對策是什麼？","quality":0.852},{"speaker":"石部長崇良","start":"2026-04-29T16:20:53.670000+08:00","guessed":false,"end":"2026-04-29T16:21:51.999000+08:00","text":"我們有幾個部分，當然透過修法是一途，過去因為沒有最低刑事責任的限制，造成最後很多都是用易科罰金處理，達不到那個嚇的阻效果，所以這次幾位委員提出的版本訂定這個刑事責任的下限，就是最低門檻，會有助於產生這個嚇阻的作用；第二個、我們也會去強化警民之間的合作，如何及時通報，尋求警方的協助；同時也要強化醫院內部自行的應變能力，包含如何處理比較會產生暴力行為的，例如酗酒、藥酒癮的患者比較會有暴力行為，要如何來防範？","quality":0.866},{"speaker":"石部長崇良","start":"2026-04-29T16:21:51.999000+08:00","guessed":false,"end":"2026-04-29T16:21:59.924000+08:00","text":"這些都應該融入在我們的教育訓練裡頭，還有醫院內部的因應機制，也都應該同步進行。","quality":0.889},{"speaker":"林委員月琴","start":"2026-04-29T16:22:00.184000+08:00","guessed":false,"end":"2026-04-29T16:22:20.171000+08:00","text":"我要提醒的是，如果立法院不斷拉高刑責的天花板，而法院卻停留在地板這樣的落差，單純的加重醫療暴力刑責，早就已經沒有嚇阻的效果；為避免衝突發生，還是需要前端的預防，相信你應該非常了解。","quality":0.915},{"speaker":"林委員月琴","start":"2026-04-29T16:22:20.951000+08:00","guessed":false,"end":"2026-04-29T16:22:47.287000+08:00","text":"就以臺大醫院雲林分院白色小組的機制為例，這個小組由行政總值、值班阿長跟保全來組成，只要醫事人員發現有狀況，馬上透過電腦系統或撥打專線就會啟動白色一號，三分鐘內白色小組就會到場介入協調，醫事人員也會感受到有人來協助他們。","quality":0.941},{"speaker":"林委員月琴","start":"2026-04-29T16:22:48.848000+08:00","guessed":false,"end":"2026-04-29T16:23:01.678000+08:00","text":"這個機制運作效果良好，隔年的醫療暴力即降為零件，我認為這是值得借鏡的模式；請問目前有沒有想要參考這樣的模式來推行？","quality":0.943},{"speaker":"石部長崇良","start":"2026-04-29T16:23:02.438000+08:00","guessed":false,"end":"2026-04-29T16:23:17.230000+08:00","text":"我想，醫院內部一定要建立這樣的應變流程，這個是應該要有的，我們會來研議把它放到評鑑裡頭，這是對病人，對所有從業人員的安全維護，是醫院應該要有的這個做法。","quality":0.986},{"speaker":"石部長崇良","start":"2026-04-29T16:23:21.273000+08:00","guessed":false,"end":"2026-04-29T16:23:29.917000+08:00","text":"至於怎麼樣做得更好，可以透過一些互相的標竿學習來落實，這個我們可以來推動。","quality":1},{"speaker":"林委員月琴","start":"2026-04-29T16:23:29.917000+08:00","guessed":false,"end":"2026-04-29T16:23:44.583000+08:00","text":"我接著要問，最近這幾年衛福部一直在努力的預立醫療，事實上它不只是一個醫療上的選擇，更是尊重個人的自主權跟尊嚴，同時也減輕家屬在面臨臨床決策時的壓力跟衝突。","quality":0.819},{"speaker":"林委員月琴","start":"2026-04-29T16:23:45.164000+08:00","guessed":false,"end":"2026-04-29T16:23:47.865000+08:00","text":"請問目前整個政策成效是什麼？","quality":0.846},{"speaker":"石部長崇良","start":"2026-04-29T16:23:48.745000+08:00","guessed":false,"end":"2026-04-29T16:24:03.434000+08:00","text":"跟委員說明，我們分兩階段，第一階段是從113年7月先開放部分條件，在住院的時候，健保給付ACP簽署預立醫療決定，從113年7月到114年4月，實施了一段時間，這當中真正申報的才190個，量非常的少。","quality":0.853},{"speaker":"石部長崇良","start":"2026-04-29T16:24:14.621000+08:00","guessed":false,"end":"2026-04-29T16:24:29.750000+08:00","text":"我們檢討之後，從114年5月開始，擴大適用健保可以給付ACP的條件，65歲以上只要有重大傷病的，我們就可以給付，在門診就可以做。","quality":1},{"speaker":"林委員月琴","start":"2026-04-29T16:24:29.750000+08:00","guessed":true,"end":"2026-04-29T16:24:30.750000+08:00","text":"對，可是我現在看成效好像不是很好……","quality":0},{"speaker":"石部長崇良","start":"2026-04-29T16:24:30.531000+08:00","guessed":false,"end":"2026-04-29T16:24:38.396000+08:00","text":"另外，如果有家醫計畫，或者有多重慢性病、65歲以上的也可以做。","quality":0.88},{"speaker":"石部長崇良","start":"2026-04-29T16:24:39.416000+08:00","guessed":false,"end":"2026-04-29T16:24:45.362000+08:00","text":"到目前為止，差不多有近兩千個，較前一波的那個政策，已大幅提升。","quality":0.926},{"speaker":"石部長崇良","start":"2026-04-29T16:24:46.002000+08:00","guessed":false,"end":"2026-04-29T16:24:57.213000+08:00","text":"不過還是有很大的努力空間，因為我們預估這樣的族群，大概超過100萬人才對，所以我們會在幾個方向來努力。","quality":1},{"speaker":"石部長崇良","start":"2026-04-29T16:24:57.413000+08:00","guessed":false,"end":"2026-04-29T16:25:21.686000+08:00","text":"第一、之前也有委員提案要修病主法，擴大可以做ACP的機構，讓更多的機構參與，因為現在都一定要醫療機構才能做，能做的醫療機構大概四百多家，可近性比較低，而且醫務人員其實也很忙。","quality":0.848},{"speaker":"石部長崇良","start":"2026-04-29T16:25:22.988000+08:00","guessed":false,"end":"2026-04-29T16:25:38.466000+08:00","text":"如何擴大參與，包含讓診所和其他的醫事機構，或是專業的團體來推動，也許可以讓這個更普及一點，我們可以來檢討、努力。","quality":0.94},{"speaker":"林委員月琴","start":"2026-04-29T16:25:39.487000+08:00","guessed":false,"end":"2026-04-29T16:25:53.156000+08:00","text":"我覺得根本問題是民眾不太理解，也不願意談死亡，我們是不是可以比照英國的方式，在推動預立醫療的時候，並不是把重點放在宣傳，而是直接放進到醫療體系裡面運作？","quality":0.943},{"speaker":"林委員月琴","start":"2026-04-29T16:25:55.718000+08:00","guessed":false,"end":"2026-04-29T16:26:05.683000+08:00","text":"在國民健康服務的體系當中，預立醫療是由醫療人員在適當時機主動去啟動，例如在慢性疾病的追蹤、高齡照護或健康狀況惡化的過程當中。","quality":0.914},{"speaker":"林委員月琴","start":"2026-04-29T16:26:06.083000+08:00","guessed":false,"end":"2026-04-29T16:26:18.990000+08:00","text":"因為家醫是他比較常互動，也是他比較信任的人，由這樣的照護團隊，直接去跟家人、病人開啟對話的討論，而不是拉出來去宣傳，我覺得這樣比較有效果。","quality":0.919},{"speaker":"林委員月琴","start":"2026-04-29T16:26:19.610000+08:00","guessed":false,"end":"2026-04-29T16:26:20.591000+08:00","text":"部長可不可以朝這個方向前進？","quality":0.846},{"speaker":"石部長崇良","start":"2026-04-29T16:26:22.752000+08:00","guessed":false,"end":"2026-04-29T16:26:37.738000+08:00","text":"目前的大家醫計畫、居診計畫、長照跟住院整合都已經納入、都可以用ACP，可能在落實度或者是推動上，還需要一點時間，因為要準備好。","quality":0.857},{"speaker":"石部長崇良","start":"2026-04-29T16:26:39.099000+08:00","guessed":false,"end":"2026-04-29T16:26:40.459000+08:00","text":"這幾個計畫都已經納入，可以執行ACP。","quality":0.941},{"speaker":"林委員月琴","start":"2026-04-29T16:26:40.459000+08:00","guessed":true,"end":"2026-04-29T16:26:44.681000+08:00","text":"接下來可以看到效果。","quality":0},{"speaker":"林委員月琴","start":"2026-04-29T16:26:44.681000+08:00","guessed":false,"end":"2026-04-29T16:27:01.571000+08:00","text":"最後一題，我在今年1月質詢，希望為身障朋友爭取到醫院能設置身障婦產科特別門診，讓他們在就醫的時候，能夠真正實現平權；後來你們回文說這個月底要公告辦法的修訂。","quality":0.859},{"speaker":"林委員月琴","start":"2026-04-29T16:27:02.391000+08:00","guessed":false,"end":"2026-04-29T16:27:10.279000+08:00","text":"可是部長，今天都29號了，直到現在我們都還沒有看到任何訊息，請問部長辦法訂好了嗎？","quality":0.714},{"speaker":"林委員月琴","start":"2026-04-29T16:27:10.279000+08:00","guessed":false,"end":"2026-04-29T16:27:10.899000+08:00","text":"什麼時候公告？","quality":1},{"speaker":"林委員月琴","start":"2026-04-29T16:27:11.340000+08:00","guessed":false,"end":"2026-04-29T16:27:14.322000+08:00","text":"如果還沒有辦法公告，明天也可以公告，因為你們講4月底啊！","quality":0.792},{"speaker":"石部長崇良","start":"2026-04-29T16:27:15.684000+08:00","guessed":false,"end":"2026-04-29T16:27:16.384000+08:00","text":"5月初一定會預告。","quality":1},{"speaker":"林委員月琴","start":"2026-04-29T16:27:17.145000+08:00","guessed":false,"end":"2026-04-29T16:27:19.446000+08:00","text":"你的5月初會「初」到什麼時候？","quality":0.909},{"speaker":"林委員月琴","start":"2026-04-29T16:27:20.527000+08:00","guessed":false,"end":"2026-04-29T16:27:21.267000+08:00","text":"我也不太確定。","quality":1},{"speaker":"林委員月琴","start":"2026-04-29T16:27:21.887000+08:00","guessed":false,"end":"2026-04-29T16:27:27.290000+08:00","text":"我不知道困難到底是什麼，因為大家等著要使用這個資源，卻都沒有辦法。","quality":0.9},{"speaker":"林委員月琴","start":"2026-04-29T16:27:28.070000+08:00","guessed":false,"end":"2026-04-29T16:27:36.134000+08:00","text":"無論如何，提供身障夥伴具有可近性的醫療環境，是我們必須努力的目標。","quality":0.967},{"speaker":"林委員月琴","start":"2026-04-29T16:27:36.434000+08:00","guessed":false,"end":"2026-04-29T16:27:39.336000+08:00","text":"部長剛剛在這邊承諾5月初……","quality":0.818},{"speaker":"石部長崇良","start":"2026-04-29T16:27:39.736000+08:00","guessed":false,"end":"2026-04-29T16:27:39.896000+08:00","text":"兩個禮拜內，我們預告……","quality":1},{"speaker":"林委員月琴","start":"2026-04-29T16:27:42.377000+08:00","guessed":false,"end":"2026-04-29T16:27:43.039000+08:00","text":"這個就不是5月初。","quality":1},{"speaker":"石部長崇良","start":"2026-04-29T16:27:43.039000+08:00","guessed":true,"end":"2026-04-29T16:27:44.441000+08:00","text":"這不是5月初，因為接下來就要放假……","quality":0.286},{"speaker":"林委員月琴","start":"2026-04-29T16:27:44.441000+08:00","guessed":false,"end":"2026-04-29T16:27:47.366000+08:00","text":"兩個禮拜已經進入到5月中，不是5月初。","quality":0.733},{"speaker":"林委員月琴","start":"2026-04-29T16:27:48.207000+08:00","guessed":false,"end":"2026-04-29T16:27:49.469000+08:00","text":"下週是不是可以公告？","quality":0.889},{"speaker":"石部長崇良","start":"2026-04-29T16:27:49.629000+08:00","guessed":false,"end":"2026-04-29T16:27:49.970000+08:00","text":"下禮拜？","quality":1},{"speaker":"石部長崇良","start":"2026-04-29T16:27:51.192000+08:00","guessed":false,"end":"2026-04-29T16:27:51.613000+08:00","text":"我們努力啦！","quality":1},{"speaker":"石部長崇良","start":"2026-04-29T16:27:51.773000+08:00","guessed":false,"end":"2026-04-29T16:27:54.838000+08:00","text":"因為條文出來還要會這個法規單位等等。","quality":1},{"speaker":"林委員月琴","start":"2026-04-29T16:27:55.819000+08:00","guessed":false,"end":"2026-04-29T16:27:56.160000+08:00","text":"最晚兩週內？","quality":1},{"speaker":"林委員月琴","start":"2026-04-29T16:27:56.160000+08:00","guessed":false,"end":"2026-04-29T16:27:56.180000+08:00","text":"好，謝謝。","quality":1},{"speaker":"石部長崇良","start":"2026-04-29T16:27:56.180000+08:00","guessed":false,"end":"2026-04-29T16:27:56.220000+08:00","text":"好，謝謝委員。","quality":0.8},{"speaker":"主席","start":"2026-04-29T16:27:56.220000+08:00","guessed":false,"end":"2026-04-29T16:27:56.641000+08:00","text":"謝謝林月琴召委的質詢。","quality":0.6},{"speaker":"主席","start":"2026-04-29T16:27:57.141000+08:00","guessed":true,"end":"2026-04-29T16:27:59.712429+08:00","text":"現在請楊曜委員質詢。","quality":0}]}},"supported_relations":[],"relations":[]}