背景：醫師的臨床自主性議題在英、美國家受到重視，但國內卻缺乏其相關研究。急診醫師在第一線處置病人，其在臨床上是否具有充份的自主性將攸關病人權益，值得注意。方法：為瞭解國內醫師之臨床自主性程度，以郵寄問卷方式進行調查，有效問卷回收數為1,304份。以描述性統計及單因子變異數分析呈現急診醫師與其他專科醫師在臨床自主性上的差異。結果：研究結果顯示急診醫師之整體臨床自主性低於多數其他專科醫師，僅高於家醫科，尤其低於外科(p<0.05)、婦產科(p<0.05)及泌尿科醫師(p<0.05)。然而，在因病患病情需要情況下，就可讓病人住院之決策上，急診醫師與其它臨床專科並無顯著差異，此點與原有對急診醫師之執業型態、常需照會與尊重其他專科之狀況不同。結論：急診醫師較其他專科醫師在臨床上的自主性相對較低，可能反映多重因素，例如急診科執業型態之特殊性以及醫院管理政策介入等，其是否可能影響病人權益，值得進一步探討。

Background: The issue of physicians' clinical autonomy has received increasing attention in U.S and UK. However, relatively less research has been conducted in Taiwan. Emergency physicians take care of patients upfront; their decisions of patient treatment plans will affect patients' right significantly. It is important to explore the factors associated with ER's perceived clinical autonomy. Method: Mailed questionnaire survey was conducted, and the number of valid questionnaires returned is 1,304. Descriptive statistics and One-Way ANOVA are employed for statistical analysis. Result: The perceived autonomy of ERs is relatively lower than that of other specialists. However, contrary to what we expect, ERs perceived similar degree of autonomy in terms of making decision to let the patients to be hospitalized when the patients' conditions with other specialists. Conclusion: The perceived low clinical autonomy of ERs may be due to multiple reasons, for example, the specificity of their practice pattern and hospital management both can cause the low perceived autonomy. Whether it will further hinder patient right for health need more investigation.