Wick Mark R, Foucar Elliott, Allen Philip W, Alves Venancio A F, Bjornsson Johannes, Bosman Fred, Churg Andrew W, Drut Ricardo, Foster Christopher S, Hauptmann Steffen, Hytiroglou Prodromos, Kuo Tseng-tong, Matsubara Osamu, Nappi Oscar, Pervez Shahid, Rosai Juan, Sasano Hironobu, Vielh Philippe, Zelger Bernhard
Department of Pathology, University of Virginia Medical Center, Charlottesville, VA 22908-0214, USA.
Semin Diagn Pathol. 2007 May;24(2):65-76. doi: 10.1053/j.semdp.2007.03.007.
An inevitable outcome of modern Medicine in any country is that some patients will experience adverse events, some of which would have been preventable. Different nations have developed various approaches to such cases; their legal efficacies are probably dissimilar and dependent on a number of disparate variables. An international "snapshot" of the results of the interacting forces can be obtained by asking physicians in several countries how they view selected subjective facets of their tort systems. In the U.S., many physicians view the structure of malpractice torts as unfair, and that belief is shared by at least some pathologists. The American Medical Association has declared that a multiregional malpractice "crisis" exists which raises medical costs and threatens access to care. Furthermore, malpractice tort decisions are often flawed scientifically because lay jurors and judges cannot properly evaluate the quality of "expert" testimony given by adversarial witnesses. Despite these factors, there has been little effort to investigate the views of pathologists on malpractice actions outside the U.S. In this paper, the authors have collected the responses of an international group of pathologists to a questionnaire on that topic. The respondents practice in academic centers in 15 countries outside the U.S. As expected, a range of views was represented, with some pathologists reporting that malpractice litigation was uncommon and others noting a worrisome trend toward its growth. Interestingly, so-called "defensive medicine" was found to be relatively common in pathology in many countries.
在任何国家，现代医学都不可避免地会出现一些患者遭遇不良事件的情况，其中一些是可以预防的。不同国家针对此类情况制定了各种方法；其法律效力可能不同，且取决于许多不同的变量。通过询问几个国家的医生对其侵权责任制度某些主观方面的看法，可以获得这些相互作用力量结果的国际“快照”。在美国，许多医生认为医疗事故侵权责任的结构不公平，至少一些病理学家也有这种看法。美国医学协会宣称存在多地区医疗事故“危机”，这增加了医疗成本并威胁到医疗服务的可及性。此外，医疗事故侵权责任的裁决在科学上往往存在缺陷，因为外行陪审员和法官无法正确评估对抗性证人提供的“专家”证词的质量。尽管存在这些因素，但在美国境外，几乎没有人努力调查病理学家对医疗事故诉讼的看法。在本文中，作者收集了一组国际病理学家对该主题问卷的回复。受访者在美国境外15个国家的学术中心工作。不出所料，观点各异，一些病理学家报告说医疗事故诉讼并不常见，而另一些人则指出其有令人担忧的增长趋势。有趣的是，所谓的“防御性医疗”在许多国家的病理学中相对普遍。
