和信治癌中心醫院 2026 年度利益關係揭露問卷 KFSYSCC 2026 Conflict of Interest Disclosure Survey
本問卷由人力資源部彙整收集，依個資法規定保密處理，僅供利益衝突委員會審閱。預計作答時間約 10 分鐘，您可隨時返回修改答案。
This survey is collected by Human Resources, kept confidential under personal data protection rules, and reviewed only by the Conflict of Interest Committee. It takes about 10 minutes to complete, and you can go back to edit any answer at any time.
請輸入您的個人問卷碼以開始作答。問卷碼已包含在人力資源部寄給您的通知信件連結中，為 16 個英數字元（例如 9EF5B4B9DF784304）。若系統未自動帶入，請於下方貼上或輸入。
Enter your personal survey code to begin. The code is in the link HR emailed to you. It is 16 letters and numbers (for example 9EF5B4B9DF784304). If it did not load automatically, paste or type it below.
系統會自動忽略您輸入的空格或符號，也不分大小寫。
Spaces, dashes, and case are ignored.
如果您找不到信件或問卷碼，請回覆人力資源部的通知信件以取得協助。
If you cannot find the email or code, please reply to HR's invitation message for help.
和信治癌中心醫院 2026 年度利益關係揭露問卷 KFSYSCC 2026 Conflict of Interest Disclosure Survey
本問卷分為 6 個部分，預計約 10 分鐘完成。您可以隨時返回上一步修改答案。 This survey has 6 sections and takes about 10 minutes. You can go back to edit any answer at any time.
我們對同仁的倫理期待 Our ethical standard
和信治癌中心醫院的病人，是在生命中最脆弱的時刻來到本院。他們把治療的判斷、用藥的選擇，甚至生死的決定，託付給我們。這份信任，是本院存在的根本。
本院對全體同仁有一個明確的倫理標準：在任何臨床、研究、行政決策上，您所做的判斷必須完全以病人的最佳利益為依歸，不受任何外部財務、個人或商業關係的影響。
Patients come to KFSYSCC at the most vulnerable moments of their lives. They place their treatment, their medication, and sometimes their life-and-death decisions in our hands. That trust is the foundation of why this hospital exists.
KFSYSCC holds all staff to a clear ethical standard: every clinical, research, and administrative judgment must be guided solely by the best interest of the patient, free from outside financial, personal, or commercial influence.
- 身份與決策角色確認Identity and decision-making role
- 院外職務（系統會帶入您 2024 年的回報）Outside positions (your 2024 entries are pre-filled)
- 與廠商的正式互動（演講、顧問、贊助研究等）Formal interactions with vendors (talks, advisory, sponsored research, etc.)
- 廠商的非正式接觸（邀請、餽贈、招待等）Informal contact from vendors (invitations, gifts, hospitality, etc.)
- 財務利益、家屬關係、院外臨床工作Financial interests, family relationships, outside clinical work
- 確認與送出Review and submit
這不是調查，也不是稽核。 本問卷由人力資源部收集，並依個資法規定保密處理，僅供利益衝突委員會審閱。當您不確定某項活動是否需要揭露時，請填寫；由委員會判斷比由您自己判斷更安全。
This is not an investigation or audit. The survey is collected by HR, kept confidential under personal data protection rules, and reviewed only by the COI Committee. When in doubt, please disclose; it is safer to let the committee decide.
身份確認 Identity confirmation
決策角色確認 Decision-making role
為什麼問這題？Why we ask this
依據本院「員工與廠商之行為規範」第 2.8 條，凡對本院儀器、藥品及衛材的使用具有決定權者，或參與採購及議價之人員，不能與廠商有任何利益關係（例如擔任股東、有給職顧問或董事）。為了讓委員會在審閱您的回答時能套用正確的標準，請先告訴我們您是否屬於此類角色。
Under §2.8 of KFSYSCC's Employee and Vendor Conduct Policy, any staff member with decision-making authority over equipment, drugs, or medical supplies (including those who participate in procurement or price negotiation) is prohibited from holding any interest relationship with a vendor such as shares, paid consulting, or a board seat. So that the committee can apply the right standard when reviewing your answers, please tell us first whether you hold any such role.
A. 院外職務 A. Outside Positions
以下是您於 2024 年申報的院外職務。請確認哪些仍持續、哪些已結束。如有新增職務，請點選下方「新增職務」按鈕一併填寫。
Below are the outside positions you reported in 2024. Please confirm which are still active and which have ended. If you have taken on any new positions since 2024, use the "Add another position" button below.
什麼算是「院外職務」？What counts as an "outside position"?
應納入範圍：
- 任何在本院以外的組織擔任的正式或非正式職務
- 有給職或無給職、全職或兼任，皆須揭露
需揭露的職務範例：
- 董事、理事、監事、受託人
- 學會會長、秘書長、幹部或委員會主委
- 顧問或諮詢委員
- 財團法人董事或執行長
- 公司負責人或合夥人
- 編輯委員或評審委員
- 講座教授或類似學術職務
What to include:
- Any formal or informal role at an organization outside KFSYSCC
- Paid or unpaid, full-time or part-time; both must be disclosed
Examples of roles that count:
- Board member, director, supervisor, trustee
- Society officer (president, secretary, committee chair)
- Advisor or consultant
- Foundation director or executive
- Company principal or partner
- Editorial board or review committee member
- Chair professor or similar academic role
B1. 與廠商的互動（過去 24 個月） B1. Interactions with vendors (past 24 months)
本節涉及您與廠商、藥廠或醫療器材公司之間的正式互動，包括受邀演講、參加贊助會議、擔任顧問、產業贊助研究等。這些活動在學術醫學界相當常見。 我們詢問的目的，是為了讓醫院在面對期刊揭露、研究倫理審查或外部查核時，能夠代您完整說明。
回顧期間：過去 24 個月。
This section covers your formal interactions with vendors, pharmaceutical companies, and medical device manufacturers, including invited talks, sponsored conferences, advisory roles, and industry-funded research. These activities are common in academic medicine. We ask so that the hospital can provide complete information on your behalf when journals, research ethics committees, or external auditors require disclosure.
Lookback period: the past 24 months.
什麼算是？如何分類？What counts, and how to categorize
- 廠商贊助包括機票、住宿、註冊費、演講費等任何形式的財務支持（無論全額或部分）。
- SAB = 科學顧問會（Scientific Advisory Board）。
- PI／Co-I = 研究計畫之主持人／共同主持人。
- 長期借用不等於短期樣品或試用。本項指廠商提供持續使用的器材或軟體（供您本人、診間、科部或研究室使用）。
- 醫學寫作協助包括廠商或其代筆公司為您撰寫或潤飾論文、評論、會議摘要或簡報內容。
- Vendor sponsorship includes travel, lodging, registration, honoraria, or any other financial support, whether whole or partial.
- SAB = Scientific Advisory Board.
- PI / Co-I = Principal Investigator / Co-Investigator on a research study.
- Long-term loan is NOT the same as a short-term sample or demo. This item is for equipment or software given for ongoing use (yours, your clinic's, your department's, or your lab's).
- Medical writing assistance includes help from a vendor-funded writer for manuscripts, review articles, conference abstracts, or presentation content.
請為每一筆勾選的互動建立一列並填寫詳細資料。 For each interaction you checked above, create one row below and fill in the details.
B2. 廠商代表的非正式接觸（過去 12 個月） B2. Informal contact from vendor representatives (past 12 months)
本節涉及廠商代表對您個人的餽贈、邀請與招待，無論您是否接受。
回顧期間：過去 12 個月。
This section covers gifts, invitations, and hospitality that vendor representatives have offered to you personally — regardless of whether you accepted.
Lookback period: the past 12 months.
本院政策與本題目的Hospital policy and why we ask
- 本院政策：本院不允許廠商與員工個人之間有任何餽贈行為，包括金錢、禮品（含文具）、餐飲及招待出遊等。
- 為何仍然詢問：廠商代表有時仍會主動提出邀請或饋贈。我們想掌握實務上的接觸情形，並非要追究責任。
- 填答範圍：過去 12 個月內，廠商曾主動提出的項目，無論您是否接受。
- The policy. KFSYSCC prohibits any gift between vendors and individual employees: money, gifts (even branded stationery), food and drink, or entertainment.
- Why we still ask. Vendors sometimes make offers anyway. We want a realistic picture of how they approach staff, not to assign blame.
- What to disclose. Anything a vendor OFFERED you in the past 12 months, regardless of whether you accepted.
C. 其他利益關係 C. Other Interests
本節涵蓋財務利益、家屬關係，以及院外的臨床工作。同樣地，這些事項本身並不違規。醫院需要掌握這些資訊，是為了在必要時能夠主動為您把關。
家屬定義：配偶、父母、子女、兄弟姊妹，或任何與您同住之人。
This section covers financial interests, family relationships, and outside clinical work. As with the earlier sections, none of these items are inherently improper. The hospital needs this information so we can proactively look out for you when needed.
Definition of family member: spouse, parents, children, siblings, or anyone living in your household.
C1. 財務利益清單（過去 24 個月） C1. Financial interests checklist (past 24 months)
請勾選下列適用於您或家屬的項目（過去 24 個月內任一時點）。
Check any item below that applies to you or a family member at any time in the past 24 months.
什麼算是「醫療相關公司」？What counts as a "healthcare-related company"?
包括：藥廠、醫療器材、診斷試劑、生技、CRO（委託研究機構）、臨床檢驗或影像、醫療資訊系統、醫療耗材等公司。
不包括：半導體、銀行、地產等與醫療無關的一般持股。
Includes: pharmaceutical, medical device, diagnostic, biotech, CRO, clinical lab, imaging, medical IT, and medical supply companies.
Does NOT include: semiconductors, banks, real estate, or other industries unrelated to healthcare.
C2. 院外臨床工作 C2. Outside clinical work
您目前是否有在本院以外的地方執行臨床業務？這包括兼診、代班、定期門診、長期顧問醫師職務、遠距醫療或線上看診，以及任何受薪或收費的臨床服務。不包括偶發性的義診或公益性活動。
Do you currently perform clinical work outside KFSYSCC? This includes moonlighting, covering shifts at another hospital or clinic, regular outpatient sessions, long-term consulting physician roles, telemedicine or online consultations, and any paid or fee-based clinical service. It does NOT include occasional volunteer clinics or charity work.
C3. 其他事項 C3. Anything else
是否有其他關係、活動或利益，無論是過去或現在，可能讓一位理性的同事認為會影響您在本院的專業判斷？當有疑慮時，歡迎告訴我們，我們可以一起看看是否需要任何協助。
Is there any other relationship, activity, or interest, past or present, that a reasonable colleague might view as potentially influencing your professional judgment at KFSYSCC? When in doubt, feel free to share it with us; we can take a look together.
確認與送出 Review and Submit
結尾聲明 Closing attestation
我確認以上資訊就我所知為完整且正確。我了解利益衝突委員會將審閱本問卷內容，並可能為了釐清細節與我聯繫。我也了解本問卷的目的是協助我與醫院妥善管理潛在的利益衝突，而非進行調查或追究責任。我也理解本院對同仁的倫理期待：在所有臨床、研究與行政決策上，必須以病人的最佳利益為唯一依歸。
I confirm that the information provided above is complete and accurate to the best of my knowledge. I understand that the Conflict of Interest Committee will review this survey and may contact me to clarify any details. I also understand that the purpose of this survey is to help me and the hospital properly manage potential conflicts of interest, and not to investigate or assign blame. I further acknowledge the ethical standard that KFSYSCC holds for its staff: that every clinical, research, and administrative decision must be guided solely by the best interest of the patient.
✓ 已送出✓ Submission received
感謝您完成 2026 年度利益關係揭露問卷。
Thank you for completing the 2026 Conflict of Interest Disclosure Survey.
確認編號：Confirmation:
接下來會發生什麼What happens next
- 您的回答已儲存至本院利益衝突委員會的審閱系統。
- 委員會審閱過程為保密，僅委員及人力資源部可查看。
- 如有任何需要釐清之處，委員會將透過 email 與您聯繫。
- 截止日期（）前，您仍可返回本連結修改答案；每次送出將建立新版本，委員會將以最新版本為準。
- Your response is stored in the COI Committee's review system.
- Review is confidential and visible only to committee members and HR.
- If anything needs clarification, the committee will email you directly.
- Before the deadline (), you can return to this link to edit your answers. Each submission creates a new revision; the committee will use your most recent version.