Tilburg Law School, Tilburg University, PO Box 90153, 5000 LE, Tilburg, the Netherlands.
Netherlands Institute for the Study of Crime and Law Enforcement, PO Box 71304, 1008 BH, Amsterdam, the Netherlands.
BMC Health Serv Res. 2022 May 16;22(1):650. doi: 10.1186/s12913-022-08021-2.
Health care incidents, such as medical errors, cause tragedies all over the world. Recent legislation in the Netherlands has established medical dispute committees to provide for an appeals procedure offering an alternative to civil litigation and to meet the needs of clients. Dispute committees incorporate a hybrid procedure where one can file a complaint and a claim for damages resulting in a verdict without going to court. The procedure is at the crossroads of complaints law and civil litigation. This study seeks to analyze to what extent patients and family members' expectations and experiences with dispute committees match the goals of the new legislation.
This qualitative, retrospective research includes in-depth, semi-structured, face-to-face interviews with patients or family members who filed a complaint with a dispute committee in the Netherlands. The researchers conducted an inductive, thematic analysis of the qualitative data.
A total of 26 interviews were held with 30 patients and family members. The results showed that participants particularly felt the need to be heard and to make a positive impact on health care. Some wished to be financially compensated, for others money was the last thing on their mind. The results demonstrated the existence of unequal power relationships between participants and both the defendant and dispute committee members. Participants reported the added value of (legal) support and expressed the need for dialogue at the hearing. Participants sometimes experienced closure after the proceedings, but often did not feel heard or felt a lack of a practical outcome and a tangible improvement.
This study shows that participants' expectations and experiences were not always met by the current set up of the dispute committee proceedings. Participants did not feel heard, while they did value the potential for monetary compensation. In addition, some participants did not experience an empowered position but rather a feeling of a power misbalance. The feeling of a power misbalance and not being heard might be explained by existing epistemic injustice, which is a concept that should be carefully considered in processes after health care incidents.
医疗事故等医疗事故在世界各地造成了悲剧。最近，荷兰的立法规定设立医疗纠纷委员会，提供上诉程序，作为民事诉讼的替代方案，并满足客户的需求。争议委员会采用混合程序，人们可以在不上法庭的情况下提出投诉和损害赔偿要求，以做出裁决。该程序处于投诉法和民事诉讼的十字路口。本研究旨在分析患者和家属对争议委员会的期望和经验在多大程度上符合新立法的目标。
这项定性、回顾性研究包括对在荷兰向争议委员会提出投诉的患者或家属进行深入、半结构化、面对面的访谈。研究人员对定性数据进行了归纳、主题分析。
共对 30 名患者和家属进行了 26 次访谈。结果表明，参与者特别感到需要被倾听并对医疗保健产生积极影响。有些人希望获得经济赔偿，而对其他人来说，金钱是他们最不关心的事情。结果表明，参与者与被告和争议委员会成员之间存在不平等的权力关系。参与者报告说（法律）支持有附加值，并表示需要在听证会上进行对话。参与者有时在诉讼程序结束后感到结束，但往往没有被倾听的感觉，或者感到缺乏实际结果和切实的改进。
本研究表明，参与者的期望和经验并不总是符合争议委员会程序的当前设置。参与者感到没有被倾听，尽管他们重视获得金钱赔偿的可能性。此外，一些参与者没有感受到授权的地位，而是感到权力失衡。权力失衡和未被倾听的感觉可能可以用现有的认识不公正来解释，这是一个应该在医疗事故后处理过程中仔细考虑的概念。
