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在医疗事故改革中通过社会制裁维持侵权行为的惩罚性因素。

Maintaining the Punitive Element of Tort through Social Sanctions in Malpractice Reform.

作者信息

Zaidi Danish

出版信息

J Leg Med. 2018 Jul-Dec;38(3-4):355-364. doi: 10.1080/01947648.2018.1476275.

Abstract

In this piece, I focus on the limitations of moving medical malpractice from a tort to contracts basis, particularly in the loss of the punishment aspect of punitive damages. In doing so, I present the way in which medical malpractice is currently implemented in the United States under tort law. I then briefly review current malpractice reform efforts, focusing more so on the idea of "no-fault" administrative systems. Here, I also explore the fundamental legal differences between contracts and tort. I then discuss the ethics of blame-shielding and whether or not we are losing something by failing to blame bad actors. In doing so, I focus on the ethical implications of punishment. Operating under the assumption that the current tort-based medical malpractice system is driving up health care costs, I conclude by proposing a hybrid system that combines contract theory with noneconomic punitive sanctions: a "no-fault fault system."

摘要

在本文中,我着重探讨将医疗事故从侵权法基础转向合同法基础的局限性,尤其是惩罚性损害赔偿中惩罚性方面的缺失。在此过程中,我阐述了美国目前在侵权法下实施医疗事故的方式。接着,我简要回顾当前的医疗事故改革努力,更侧重于“无过错”行政系统的理念。在此,我还探究了合同法与侵权法之间的根本法律差异。然后,我讨论了责任规避的伦理问题,以及我们是否因未能追究不良行为者的责任而有所损失。在此过程中,我着重探讨惩罚的伦理影响。基于当前基于侵权法的医疗事故制度正在推高医疗成本这一假设,我最后提出一种将合同理论与非经济性惩罚性制裁相结合的混合制度:“无过错过错制度”。

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