Welch C E
N Engl J Med. 1975 Jun 26;292(26):1372-6. doi: 10.1056/NEJM197506262922604.
Medical liability insurance is in a state of emergency brough on by escalating premiums or withdrawal of insurance companies from the market. Solutions, supported by legislation, must be sought for the sake of both patient and physician. As a temporary method of correction joint underwriting associations appear to be the most practical suggestion. Long-range changes should include the establishment of powerful malpractice arbitration boards whose conclusions and evidence would be submitted in case of further appeal, the delegation of more power to the medical profession to enforce standards, shortening of the period specified in the statutes of limitation, limitations on contingency fees, and elimination of the applicability of such legal doctrines as ad damnum clauses and res ipsa loquitur.
医疗责任保险正处于紧急状态,这是由保费不断上涨或保险公司退出市场所致。为了患者和医生双方的利益,必须寻求立法支持的解决方案。作为一种临时的纠正方法,联合承保协会似乎是最切实可行的建议。长期的变革应包括设立强大的医疗事故仲裁委员会,其结论和证据在进一步上诉时应予以提交;赋予医疗行业更多权力以执行标准;缩短诉讼时效法规规定的期限;限制胜诉酬金;以及消除诸如损害赔偿条款和事实自证等法律原则的适用性。