本文討論風險變更結果歸責的難題，在客觀歸責理論幾近蔚為通說後，學說上對於所謂的風險降低的案例，原則上大多認為於客觀構成要件解決；而對於風險變更或是風險替代的案例，則認為原則上於違法性解決，例外於不可抗力因素介入時，阻卻客觀構成要件該當。近年來，更有部分德國學者嘗試重新定義因果關係、構成要件結果或是積極引入假設因果關係等規範性的思考，希望將所有風險降低或變更案例提前於構成要件解決，而不 再落入違法性階層予以評價。 然而，以下本文將於討論以上學說趨勢後，嘗試反駁上述以 假設因果關係重新定位風險變更案例的想法，本文將指出，無論 是學說上提出的風險降低以及風險變更，其實它們涉及的都是二 個不同風險的替換，而不是同一個風險的變化，是以，基於風險 替換涉及法益大小比較的問題，應該全面於違法性階層加以解 決。此不但具有學理上的討論價值，更重要的毋寧在於，本文之 意見對於被害人的自我決定權和醫療刑法的病人自主，饒富法理 上意義。是以，本文於討論完抽象的法理基礎後，便嘗試將觀察 視角拉回醫療刑法上有關於風險變更的思考，於此，本文討論了 我國醫療刑法上一個歷久不衰的爭議— 告知後同意原則 （Informed Consent），試圖由基礎理論落實至具體的實踐層次， 示範本文提出標準之可操作性。

This article discusses the problem of risk changes, the theory of objective attribution almost universal, the doctrine of the so-called case of risk reduction, in principle, most of them considered in the objective elements of the solution; and for risk changes or risk alternatives case, Then it is considered that, in principle, when illegality is to be resolved, except when the force majeure is involved, the obstruction of the objective constitutional elements should be avoided. In recent years, some German scholars try to redefine causal relationships, the formation of the elements of the results or the positive introduction of hypothetical causal relationships and other normative thinking, hoping all the risk reduction or change cases in advance of the constituent elements to solve, and no longer fall under the law Class to be evaluated. However, after discussing the above trend, this essay tries to disprove the above-mentioned idea of repositioning the case of risk change based on hypothetical causality. This article will point out that both the doctrine proposed risk reduction and risk change actually involve two The replacement of different risks, rather than the same change of risk, therefore, based on the risk of replacement involves the size of the legal benefit comparison, should be comprehensive in the illegitimate class to be resolved. This not only has the value of academic discussion, but more important rather, the opinion of this article is of great significance to the victim's selfdetermination and patient autonomy in medical criminal law. Therefore, after discussing the abstract legal basis, this article attempts to bring back the observational perspective to the medical criminal law. This article discusses a long-standing dispute in Taiwan's medical criminal law- Informed Consent. Try to implement the basic theory from the basic theory to the specific level of practice, and demonstrate the operability of the standard.