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妇产科医疗事故危机:有解决办法吗?

The malpractice crisis in obstetrics and gynecology: is there a solution?

作者信息

Barber H R

机构信息

Department of Obstetrics and Gynecology, Lenox Hill Hospital, New York, New York.

出版信息

Bull N Y Acad Med. 1991 Mar-Apr;67(2):162-72.

Abstract

The malpractice ripoff began when the no-fault automobile accident law was passed. Many lawyers were in a panic at this time and turned to medical malpractice litigation to make a living. It became the conduit to quick wealth. The patient was the loser, the lawyer the winner, and the physician often devastated by the patient's ingratitude. For a patient-plaintiff to maintain a successful lawsuit for medical negligence against a physician, four elements must be alleged and proved in a court of law: duty, breach of duty, causation, and damages. Each must be proved by a patient to prevail against a physician. Since this is very difficult to do, the lawyers have subtly brought in a new approach called maloccurrence. This is defined as a bad outcome unrelated to the quality of care provided. The lawyers need not prove the four elements to win a malpractice case; many are won on deceit and in violation of the law by introducing the concept of maloccurrence. Not only are tort reforms needed but out of court alternatives must be mandated by law or our health care delivery system will be destroyed. Government interference and the malpractice ripoff has had a devastating effect on the talent attracted to medical school, and the number of applicants is falling rapidly. The medical malpractice crisis could soon be translated into a health delivery service crisis. Concerned citizens must join together with the medical profession and leaders of the legal profession to halt this monstrous injustice. The litigation milieu has not only paralyzed the health care industry but it has had a devastating effect across the board on the way Americans live and do business. It must be solved now for justice delayed is justice denied.

摘要

医疗事故欺诈始于无过错汽车事故法的通过。当时许多律师陷入恐慌,转而从事医疗事故诉讼以维持生计。它成了快速致富的途径。患者是输家,律师是赢家,而医生常常因患者的忘恩负义而深受打击。患者原告要想成功起诉医生医疗过失,必须在法庭上指控并证明四个要素:义务、违反义务、因果关系和损害赔偿。患者必须证明每一个要素才能胜诉。由于这很难做到,律师们巧妙地引入了一种新方法,称为不良事件。这被定义为与所提供护理质量无关的不良后果。律师们无需证明这四个要素就能赢得医疗事故案件;许多案件是通过引入不良事件的概念,靠欺骗和违法手段打赢的。不仅需要侵权法改革,还必须依法规定庭外解决纠纷的替代方案,否则我们的医疗保健服务体系将被摧毁。政府干预和医疗事故欺诈对医学院吸引人才产生了毁灭性影响,申请人数正在迅速下降。医疗事故危机可能很快就会演变成医疗服务危机。关注此事的公民必须与医学界和法律界领袖联合起来,制止这种巨大的不公。诉讼环境不仅使医疗行业陷入瘫痪,而且对美国人的生活和经商方式产生了全面的毁灭性影响。必须立即解决这个问题,因为迟到的正义即非正义。

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