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改革医学与侵权法之间的关系。

Reforming the relationship between medicine and the law of tort.

作者信息

Gray Natalie

机构信息

Royal Prince Alfred Hospital, Camperdown, New South Wales.

出版信息

J Law Med. 2004 Feb;11(3):324-30.

Abstract

The Australian Government's medical indemnity package is predicated on the belief that the current crisis is primarily one of insurance. However, an examination of the fault-based tort system illustrates that, irrespective of their insurance status, doctors are profoundly affected by the adversarial process and their response to it is leading to sub-optimal patient care. This article argues that the adversarial system of medical negligence fails to satisfy the main aims of tort law, those being equitable compensation of plaintiffs, correction of mistakes and deterrence of negligence. Instead, doctors experience litigation as a punishment and, in order to avoid exposure to the system, have resorted not to corrective or educational measures but to defensive medicine, a practice which the evidence indicates both decreases patient autonomy and increases iatrogenic injury. This is unacceptable and suggests that the package has missed the point. This article proposes an alternative medico-legal tort scheme which attempts to overcome some of these problems.

摘要

澳大利亚政府的医疗赔偿方案基于这样一种信念,即当前的危机主要是保险方面的危机。然而,对基于过错的侵权制度的审视表明,无论医生的保险状况如何,他们都深受对抗性程序的影响,而他们对此的反应正导致患者护理达不到最佳水平。本文认为,医疗过失的对抗性制度未能实现侵权法的主要目标,即对原告的公平赔偿、纠正错误以及威慑过失行为。相反,医生将诉讼视为一种惩罚,并且为了避免卷入该制度,他们采取的不是纠正或教育措施,而是防御性医疗,有证据表明这种做法既降低了患者的自主性,又增加了医源性伤害。这是不可接受的,表明该方案没有抓住问题的关键。本文提出了一种替代性的医疗法律侵权方案,试图克服其中的一些问题。

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