Hamasaki Tomoko, Hagihara Akihito
Department of Nutrition, Faculty of Home Economics, Kyushu Women's University, Kitakyushu, Fukuoka, Japan.
Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
Int Dent J. 2021 Aug;71(4):300-308. doi: 10.1016/j.identj.2020.12.004. Epub 2021 Feb 10.
Dental litigation accounts for approximately 10% of medical cases in Japan. This study sought to identify factors related to dentists' legal liability in Japan, including their duty to explain procedures and treatments to their patients.
We analysed court decisions in 166 dental malpractice cases litigated in Japan between 1978 and 2017. To identify factors related to the legal liability of dentists, an analysis was performed to evaluate the associations among patient characteristics, dentist characteristics, litigation, and dentists' explanatory behaviour.
Of the 36 cases related to dentist liability, the study identified 23 cases (63.9%) of litigation in which the dentists were found to be in violation of their duty to provide an explanation. Regarding the severity of injury, the ratio of death and permanent disability was significantly higher in decisions in which the purpose of the explanation was something other than obtaining the patient's consent compared with decisions to obtain the patient's consent (P = .014).
In cases in which the dentist was found legally responsible, the proportion of cases involving procedural negligence with the explanation of medical guidance was significantly higher. Dentists should pay careful attention not only to the patient's consent but also to their explanations, including "medical guidance." Moreover, they should recognise that inappropriate explanations correlate with serious errors.
在日本,牙科诉讼约占医疗案件的10%。本研究旨在确定与日本牙医法律责任相关的因素,包括他们向患者解释治疗程序和治疗方法的义务。
我们分析了1978年至2017年期间在日本提起诉讼的166起牙科医疗事故案件的法院判决。为了确定与牙医法律责任相关的因素,我们进行了一项分析,以评估患者特征、牙医特征、诉讼和牙医解释行为之间的关联。
在36起与牙医责任相关的案件中,该研究确定了23起(63.9%)诉讼案件,其中牙医被认定违反了提供解释的义务。关于伤害的严重程度,与旨在获得患者同意的判决相比,在解释目的不是获得患者同意的判决中,死亡和永久残疾的比例显著更高(P = 0.014)。
在认定牙医负有法律责任的案件中,涉及医疗指导解释方面程序疏忽的案件比例显著更高。牙医不仅应密切关注患者的同意,还应关注他们的解释,包括“医疗指导”。此外,他们应认识到不适当的解释与严重错误相关。