本文說明德國法上醫療過失舉證責任之現況與發展。 在德國，醫療民事責任亦應適用民事責任一般原則，即被害人請求賠償損害，係以契約責任，或侵權責任為依據。 病人起訴請求醫師或醫院賠價損害時，應就醫療之瑕疵(Fehler)、醫師或醫院或其履行輔助人之過失(Verschulden )、醫療瑕疵與損害之因果關係(Ursächlichkeit )等三項構成要件，負舉證責任。 然而，鑑於病人與醫師或醫院間資訊絕對不對稱之情形，德國醫療訴訟實務致力於公平分配舉證責任，並適度減輕及合理轉換病人之舉證責任。德國法院認為，病人係於醫師或醫院所控制之人員、機器設備、地點或其他風險範圍內受損害者，病人之舉證責任即得減輕或轉換之。醫師違反其病情資訊記載義務或說明義務時，亦同。病人係因醫師或醫院之重大醫療瑕疵而受有損害者，更應轉換由醫師或醫院負舉證責任。

This article explains the current situation and developments of the burden of proof in German medical malpractice. In Germany, the general principles of civil liabi1ity also apply to the liability for medical malpractice. In other words, the plaintiff has to base his/her claim for compensation either on breach of contract or on tort. A patient claiming damage against the physician or hospital must prove three elements: defect in the medical treatment, negligence of the physician, hospital or their assistants, and the causation between the defective medical treatment and the damage. However, in consideration of the absolute imbalance of available information between the patient and the medical provider, the German legal practice devotes to fairly assigning the burden of proof between the parties and adequately lightening or even reasonably reversing the patient's burden of proof. The German courts express the opinion that if the patient is injured within the scope of the personnel, equipment, facility, or any other kind of risk factors controlled by the physician or hospital, the patient's burden of proof shall be lightened or reversed. The same applies in the case where the physician violates his or her obligation to maintain medical records or to inform. The burden of proof shall in particular be shifted to the physician or hospital when the injuries caused to the patient are due to gross medical defect of the physician or hospital.